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Aspirin (ASA) is an essential component of peri–percutaneous coronary intervention (PCI) pharmacotherapy. Prior studies suggest that ASA is not administered to a small but clinically significant number of patients before undergoing PCI.
We evaluated the incidence of PCI's performed without pre–procedural administration of ASA among patients undergoing PCI from January 2010 to December 2011 at 42 hospitals in Michigan and enrolled in the BMC2 PCI multicenter registry. Propensity matched multivariate analysis was used to adjust for the non–random absence of ASA prior to PCI.
Our study population was comprised of 65,175 patients of whom 4,640 (7.1 %) did not receive ASA within the 24 hours prior to undergoing PCI. When compared with ASA receivers, non–receivers were more likely to have had prior gastrointestinal bleeding, to present in cardiogenic shock or following cardiac arrest. They had worse in–hospital outcomes (unadjusted mortality 3.9% vs. 1.2%). In the propensity matched analysis, absence of ASA prior to PCI was associated with higher rate of death (3.9% vs. 2.8%, odds ratio 1.89, 95% CI 1.32–2.71, p= 0.005) and stroke (0.5% vs. 0.1%, odds ratio of 4.24, 95% CI 1.49–12.11, p= 0.007) with no difference in bleeding, need for transfusions or contrast induced nephropathy (Fig. 1).
A significant number of patients do not receive aspirin prior to undergoing PCI. Lack of aspirin prior to PCI was associated with significantly increased in–hospital mortality.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Adjunct Pharmacology
Abstract Category: 39. TCT@ACC–i2: Adjunct Pharmacology
Presentation Number: 2115M–217
- 2013 American College of Cardiology Foundation