Predictors of bleeding complications and thrombocytopenia with the use of abciximab during percutaneous coronary intervention.

Abciximab (c7e3; ReoPro; Centocor, Inc., Pennsylvania, USA), a Fab fragment of the chimeric human-murine monoclonal antibody directed against platelet glycoprotein IIb/IIIa receptors, has been shown to reduce acute ischemic complications in patients undergoing percutaneous coronary interventions (PCI). However, its use has been associated with an increased incidence of bleeding events. The aim of this study is to examine the frequency of bleeding complications and to identify clinical variables associated with it in our patients. We prospectively recorded incidence of bleeding complications in 344 consecutive patients who underwent PCI with adjunctive use of abciximab (Ab). Clinical predictors for patients who developed bleeding complications with Ab were compared with the nonbleeders. Major bleeding occurred in six patients (1.7%) one of whom had pulmonary hemorrhage and one had intracranial hemorrhage. Minor bleeding occurred in 20 (5.8%) patients. Thrombocytopenia was seen in 13 (3.9%) patients of which four (1.2%) were mild, four (1.2%) were severe, and five (1.5%) were profound. Multivariate analyses showed that female gender and the "bail-out" use of Ab were risk factors for bleeding complications. The rate of major bleeding complications and thrombocytopenia were low and comparable with published trials. Female patients and those who received Ab as a "bail-out" were at higher risk of developing bleeding complications.