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Correlates and consequences of gastrointestinal bleeding complicating percutaneous coronary intervention.

Gaglia, MA, Torguson, R, Gonzalez, MA, Ben-Dor, I, Maluenda, G, Collins, SD, Syed, AI, Delhaye, C, Wakabayashi, K, Belle, L, Mahmoudi, M, Hanna, N, Xue, Z, Kaneshige, K, Suddath, WO, Kent, KM, Satler, LF, Pichard, AD and Waksman, R (2010) Correlates and consequences of gastrointestinal bleeding complicating percutaneous coronary intervention. Am J Cardiol, 106 (8). pp. 1069-1074.

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Abstract

Gastrointestinal bleeding (GIB) complicating percutaneous coronary intervention (PCI) results in high mortality, but clinical factors associated with and long-term outcomes of GIB are poorly understood. We sought to examine clinical and procedural factors associated with GIB complicating PCI. We also examined the impact of GIB on 30-day mortality and 1-year major adverse cardiac events (MACEs). Patients undergoing PCI from January 2000 to January 2010 were retrospectively analyzed for the occurrence of in-hospital GIB. Multivariable logistic regression and Cox proportional hazards regression were used to identify predictors of in-hospital GIB and 30-day mortality. Landmark analysis of patients surviving to hospital discharge was performed to assess the impact of GIB on 1-year MACEs. Of 20,621 patients who underwent PCI, 147 (0.72%) who developed in-hospital GIB were identified. Variables associated with increased risk of GIB included older age, shock, acute myocardial infarction, chronic renal insufficiency, lower baseline hematocrit, and glycoprotein IIb/IIIa inhibitors; bivalirudin decreased the risk. Unadjusted 30-day mortality rate of patients with GIB was 20.5% compared to 2.4% of patients without GIB. After multivariable adjustment, GIB and shock (and an interaction between the 2) were the most important correlates of 30-day mortality. In the population surviving to discharge, however, GIB was not associated with adjusted mortality or MACEs. In conclusion, GIB complicating PCI has a dramatic impact on 30-day mortality, and bivalirudin was associated with lower rates of GIB.

Item Type: Article
Authors :
NameEmailORCID
Gaglia, MAUNSPECIFIEDUNSPECIFIED
Torguson, RUNSPECIFIEDUNSPECIFIED
Gonzalez, MAUNSPECIFIEDUNSPECIFIED
Ben-Dor, IUNSPECIFIEDUNSPECIFIED
Maluenda, GUNSPECIFIEDUNSPECIFIED
Collins, SDUNSPECIFIEDUNSPECIFIED
Syed, AIUNSPECIFIEDUNSPECIFIED
Delhaye, CUNSPECIFIEDUNSPECIFIED
Wakabayashi, KUNSPECIFIEDUNSPECIFIED
Belle, LUNSPECIFIEDUNSPECIFIED
Mahmoudi, Mm.mahmoudi@surrey.ac.ukUNSPECIFIED
Hanna, NUNSPECIFIEDUNSPECIFIED
Xue, ZUNSPECIFIEDUNSPECIFIED
Kaneshige, KUNSPECIFIEDUNSPECIFIED
Suddath, WOUNSPECIFIEDUNSPECIFIED
Kent, KMUNSPECIFIEDUNSPECIFIED
Satler, LFUNSPECIFIEDUNSPECIFIED
Pichard, ADUNSPECIFIEDUNSPECIFIED
Waksman, RUNSPECIFIEDUNSPECIFIED
Date : 15 October 2010
Identification Number : https://doi.org/10.1016/j.amjcard.2010.06.011
Uncontrolled Keywords : Aged, Angioplasty, Balloon, Coronary, Anticoagulants, Antithrombins, Blood Transfusion, Drug-Eluting Stents, Female, Follow-Up Studies, Gastrointestinal Hemorrhage, Hirudins, Humans, Incidence, Inpatients, Male, Middle Aged, Myocardial Infarction, Peptide Fragments, Postoperative Hemorrhage, Prognosis, Recombinant Proteins, Retrospective Studies, Risk Factors, Survival Rate, Time Factors, United States
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 09:47
Last Modified : 17 May 2017 09:47
URI: http://epubs.surrey.ac.uk/id/eprint/825112

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