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Background: Given the use of antithrombotic agents during percutaneous coronary intervention (PCI), patients (pts) with a history of gastrointestinal bleeding (GIB) are thought to be at risk for adverse outcomes after PCI. However, there are limited data on the outcomes of PCI in patients with recent GIB.
Methods: Of 98,730 pts who underwent PCI from 1/1/2013 – 3/31/2016 at 47 Michigan hospitals, 1,143 (1.2%) had a history of GIB defined as “any occurrence of melena or hematemesis in the last 30 days or any history of GIB including peptic ulcer disease that may influence clinical management during this hospitalization.” In-hospital outcomes included stroke, transfusion, bleeding, major bleeding and death. Propensity-matched multivariable analysis was used to adjust for differences in baseline characteristics.
Results: Pts with a history of GIB were more likely to be older, female, African American, and have more cardiovascular comorbidities. After matching (n=1,109 per group), a history of GIB was significantly associated with increased post-procedural transfusion (19.4% vs. 11.6%; P<0.001), bleeding (11.7% vs. 6.1%; P<0.001), and major bleeding (2.5% vs. 0.5%; P=0.002) (Figure). There were no significant differences in stroke (0.8% vs. 0.9%; P=0.91) or death (6.8% vs 5.2%; P=0.095).
Conclusions: A history of GIB was significantly associated with an increased risk of bleeding but not stroke or death after PCI. This risk factor should be routinely ascertained when assessing PCI bleeding risk.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: PCI for NSTEMI and Complex Patients With Multiple Co-Morbidities
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1154-143
- 2017 American College of Cardiology Foundation