Prognostic value of bleeding after percutaneous coronary intervention in patients with diabetes

EuroIntervention. 2014 May;10(1):83-9. doi: 10.4244/EIJV10I1A14.

Abstract

Aims: The aim of this study was to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients with type 2 diabetes.

Methods and results: This study included 4,329 diabetic patients who underwent PCI. Bleeding was assessed using the Bleeding Academic Research Consortium criteria. The primary outcome was one-year mortality. Bleeding events occurred in 474 patients (10.9%). Access-site and non-access-site bleeds occurred in 274 patients (58%) and 200 patients (42%), respectively. Within the first year after PCI there were 198 deaths: 45 deaths (9.6%) among patients with bleeding and 153 deaths (4.0%) among patients without bleeding (adjusted hazard ratio=2.04 [95% confidence interval 1.38-3.00], p<0.001). There were 25 deaths (12.7%) among patients with non-access-site bleeding and 20 deaths (7.4%) among patients with access-site bleeding (odds ratio [OR]=3.45 [2.20-5.41], p<0.001 for non-access-site bleeding vs. no bleeding and OR=1.90 [1.17-3.01], p=0.008 for access-site bleeding vs. no bleeding). Bleeding improved the discriminatory power of the multivariable model for mortality prediction (p=0.002).

Conclusions: In patients with diabetes undergoing PCI, occurrence of bleeding within the first 30 days after PCI was associated with a significant increase in the risk of one-year mortality.

MeSH terms

  • Abciximab
  • Aged
  • Antibodies, Monoclonal / adverse effects
  • Anticoagulants / adverse effects*
  • Antithrombins / adverse effects*
  • Aspirin / adverse effects
  • Clopidogrel
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Hemorrhage / chemically induced*
  • Hemorrhage / mortality
  • Heparin / adverse effects
  • Hirudins / adverse effects
  • Humans
  • Immunoglobulin Fab Fragments / adverse effects
  • Logistic Models
  • Male
  • Middle Aged
  • Peptide Fragments / adverse effects
  • Percutaneous Coronary Intervention*
  • Platelet Aggregation Inhibitors / adverse effects*
  • Prognosis
  • Proportional Hazards Models
  • Recombinant Proteins / adverse effects
  • Risk Factors
  • Stents*
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives

Substances

  • Antibodies, Monoclonal
  • Anticoagulants
  • Antithrombins
  • Hirudins
  • Immunoglobulin Fab Fragments
  • Peptide Fragments
  • Platelet Aggregation Inhibitors
  • Recombinant Proteins
  • Heparin
  • Clopidogrel
  • Ticlopidine
  • Aspirin
  • bivalirudin
  • Abciximab