Bleeding in patients Undergoing Percutaneous Coronary Intervention (PCI)
Abstract
Objectives: To study the frequency of bleeding and associated risk factors among patients undergoing Percutaneous Coronary Intervention (PCI).
Methodology: This cross-sectional study was conducted on 500 consecutive patients, who underwent PCI at Punjab Institute of Cardiology, Lahore. Bleeding was defined according to REPLACE – 2 criteria.
Results: There were 82 females (16.4%) and 418 males (83.6%); mean age 53.4 (± 9.6 years). Bleeding complications occurred in 6.2% (n=31) of patients; major bleed 0.8% (n= 4) and minor bleed 5.6% (n= 27). One patient with major bleed (retroperitoneal) died in hospital. The frequency of bleeding complications was 8.5% among females and 5.7% among males (P=0.24). Radial route was used in majority (88.6%). The risk factors found to be significantly associated with the development of post-PCI bleeding were diabetes (OR: 6.4; P < 0.0001), hypertension (OR: 13.2; P < 0.0001), smoking (OR:8.31; P < 0.0001) and BMI > 40 (OR: 6.8; P < 0.002), use of streptokinase (OR: 3.1; P < 0.0005), femoral approach (OR:4.2; P < 0.02), anaemia (OR: 44.8; P < 0.0001) and ACT ? 350 ( OR: 3.73; P < 0.0005). In our study, female gender, procedure time ? 60 minutes, use of Glycoproteins IIb/IIIa inhibitors (GPI), and patient’s age ? 50 years did not show significant association with post PCI bleeding.
Conclusion: Major bleeding complications during Percutaneous Coronary Intervention (PCI) though occur rarely, are an important cause of patient morbidity and mortality.
Methodology: This cross-sectional study was conducted on 500 consecutive patients, who underwent PCI at Punjab Institute of Cardiology, Lahore. Bleeding was defined according to REPLACE – 2 criteria.
Results: There were 82 females (16.4%) and 418 males (83.6%); mean age 53.4 (± 9.6 years). Bleeding complications occurred in 6.2% (n=31) of patients; major bleed 0.8% (n= 4) and minor bleed 5.6% (n= 27). One patient with major bleed (retroperitoneal) died in hospital. The frequency of bleeding complications was 8.5% among females and 5.7% among males (P=0.24). Radial route was used in majority (88.6%). The risk factors found to be significantly associated with the development of post-PCI bleeding were diabetes (OR: 6.4; P < 0.0001), hypertension (OR: 13.2; P < 0.0001), smoking (OR:8.31; P < 0.0001) and BMI > 40 (OR: 6.8; P < 0.002), use of streptokinase (OR: 3.1; P < 0.0005), femoral approach (OR:4.2; P < 0.02), anaemia (OR: 44.8; P < 0.0001) and ACT ? 350 ( OR: 3.73; P < 0.0005). In our study, female gender, procedure time ? 60 minutes, use of Glycoproteins IIb/IIIa inhibitors (GPI), and patient’s age ? 50 years did not show significant association with post PCI bleeding.
Conclusion: Major bleeding complications during Percutaneous Coronary Intervention (PCI) though occur rarely, are an important cause of patient morbidity and mortality.
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