OBJECTIVES: To evaluate the effect of vascular complications (VC) on the adjusted risk of nonfatal myocardial infarction (MI) or death following percutaneous coronary intervention (PCI) at 1 year in a large contemporary cohort. BACKGROUND: Peri-procedural bleeding increases the risk of adverse clinical outcomes at 1 year. Whether access site VC's identify patients at high risk or independently alter the risk of adverse clinical outcomes at 1 year, however, is uncertain. METHODS: 3,931 PCI procedures performed via a femoral access at a single site (WFUBMC) were evaluated. Access and nonaccess site post procedural bleeding were assessed. The adjusted risk of access site VC's association with 1-year clinical outcomes was evaluated by Cox proportional hazards modeling. RESULTS: Any VC occurred in 1.7%, and any TIMI bleeding in 6.7% after PCI. The hazard ratio (HR) adjusted for baseline and procedural covariates for any VC of nonfatal MI or all cause death at 1 year was 1.68 (1.00-2.81), P = 0.049 and 1.69 (0.92-3.09), P = 0.088 for all cause death alone. However, after adjusting for any TIMI bleeding, the HR for nonfatal MI or death was 0.84 (0.49-1.45), P = 0.527, and for death alone 0.75 (0.39-1.41), P = 0.369. CONCLUSIONS: The occurrence of VC following PCI was an independent predictor of nonfatal MI or death at 1 year, but only if accompanied by TIMI major or minor bleeding. A vascular complication without TIMI bleeding did not alter prognosis at 1 year. Copyright 2009 Wiley-Liss, Inc.
OBJECTIVES: To evaluate the effect of vascular complications (VC) on the adjusted risk of nonfatal myocardial infarction (MI) or death following percutaneous coronary intervention (PCI) at 1 year in a large contemporary cohort. BACKGROUND: Peri-procedural bleeding increases the risk of adverse clinical outcomes at 1 year. Whether access site VC's identify patients at high risk or independently alter the risk of adverse clinical outcomes at 1 year, however, is uncertain. METHODS: 3,931 PCI procedures performed via a femoral access at a single site (WFUBMC) were evaluated. Access and nonaccess site post procedural bleeding were assessed. The adjusted risk of access site VC's association with 1-year clinical outcomes was evaluated by Cox proportional hazards modeling. RESULTS: Any VC occurred in 1.7%, and any TIMI bleeding in 6.7% after PCI. The hazard ratio (HR) adjusted for baseline and procedural covariates for any VC of nonfatal MI or all cause death at 1 year was 1.68 (1.00-2.81), P = 0.049 and 1.69 (0.92-3.09), P = 0.088 for all cause death alone. However, after adjusting for any TIMI bleeding, the HR for nonfatal MI or death was 0.84 (0.49-1.45), P = 0.527, and for death alone 0.75 (0.39-1.41), P = 0.369. CONCLUSIONS: The occurrence of VC following PCI was an independent predictor of nonfatal MI or death at 1 year, but only if accompanied by TIMI major or minor bleeding. A vascular complication without TIMI bleeding did not alter prognosis at 1 year. Copyright 2009 Wiley-Liss, Inc.
Authors: Bina Ahmed; Stefan Lischke; Mike De Sarno; Leigh Ann Holterman; Faye Straight; Harold L Dauerman Journal: J Thromb Thrombolysis Date: 2013-07 Impact factor: 2.300
Authors: Johannes Ketterle; Harald Rittger; Inga Helmig; Lutz Klinghammer; Stefan Zimmermann; Wolfgang Hohenforst-Schmidt; Johannes Brachmann; Holger Nef; Stephan Achenbach; Christian Schlundt Journal: Herz Date: 2015-06-13 Impact factor: 1.443