AustralieFrV1, Istex, Checkpoint, bibRecord, 000644

Bleeding complications in primary percutaneous coronary intervention of ST‐elevation myocardial infarction in a radial center

Identifieur interne : 000644 ( Istex/Checkpoint ); précédent : 000643; suivant : 000645

Bleeding complications in primary percutaneous coronary intervention of ST‐elevation myocardial infarction in a radial center

Auteurs : Olivier Barthélémy [France] ; Johanne Silvain [France] ; David Brieger [France, Australie] ; Anne Mercadier [France] ; Remi Lancar [France] ; Anne Bellemain-Appaix [France] ; Farzin Beygui [France] ; Jean Philippe Collet [France] ; Dominique Costagliola [France] ; Gilles Montalescot [France]

Source :

Catheterization and Cardiovascular Interventions [ 1522-1946 ] ; 2012-01-01.

RBID : ISTEX:C6DB9CFBB5D0138421F57C9EEAB898D877D12A48

English descriptors

Abstract

Objectives: We evaluated the incidence, types, and prognostic impact of bleeding complications in a non‐selected patient population with ongoing STEMI treated with aggressive antithrombotic treatment and routine radial primary PCI. Background: Bleeding complications remain frequent and deleterious in primary PCI through femoral approach. Methods: STEMI patients (n = 671) were evaluated for bleeding complications using a web‐based registry (e‐PARIS). In‐hospital bleeding was adjudicated using the TIMI definition. Results: In this non‐selected, high risk population, 6.1% had cardiogenic shock on admission, 3.9% out‐of‐hospital cardiac arrest. Radial access (88%) was the default strategy as was abciximab (78%). Clopidogrel loading dose ranged from 300 to 900 mg. Pre‐hospital fibrinolysis was rare (7.1%). Hemodynamic support devices (IABP, ECMO, Tandem Heart) were needed in 7.0%. In‐hospital TIMI Major and TIMI Major/minor bleedings occurred in 2.5 and 5.7% of the population, respectively. In‐hospital and 1‐year mortality rates were 5.5 and 8.2%, respectively. Patients with in‐hospital TIMI Major/minor bleeding had a higher 1‐year mortality rate (31.6% vs. 3.8%, P < 0.001). The most frequent bleeding site was gastro‐intestinal. Radial access was a strong predictor of survival (OR 0.33; 95%CI 0.17–0.56; P = 0.002). Conclusions: In the setting of radial primary PCI, the rates and types of bleeding complications are somewhat different from those observed with femoral primary PCI. The gastro‐intestinal tract has become the most frequent site of bleeding after radial primary PCI. The use of radial access appears independently associated with survival. © 2011 Wiley Periodicals, Inc

Url:

https://api.istex.fr/document/C6DB9CFBB5D0138421F57C9EEAB898D877D12A48/fulltext/pdf

DOI: 10.1002/ccd.23164

Affiliations:

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acuity trial</term>
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<term>Clinical outcomes</term>
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<term>Complication</term>
<term>Default strategy</term>
<term>Expert consensus document</term>
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<term>Acute elevation</term>
<term>Acute stemi</term>
<term>Aggressive antithrombotic therapy</term>
<term>Angiography</term>
<term>Antiplatelet therapy</term>
<term>Antithrombotic</term>
<term>Antithrombotic therapy</term>
<term>Baseline</term>
<term>Boston cordis</term>
<term>Cardiogenic shock</term>
<term>Cardiol</term>
<term>Cardiologie</term>
<term>Cardiovascular</term>
<term>Cardiovascular angiography</term>
<term>Cardiovascular interventions</term>
<term>Catheterization</term>
<term>Circulatory support</term>
<term>Clinical outcomes</term>
<term>Coll cardiol</term>
<term>Complication</term>
<term>Default strategy</term>
<term>Expert consensus document</term>
<term>Federation francaise</term>
<term>Femoral</term>
<term>Femoral access</term>
<term>Femoral approach</term>
<term>French blood establishment</term>
<term>Frequent site</term>
<term>Granger</term>
<term>High risk population</term>
<term>Higher risk</term>
<term>Iabp</term>
<term>Independent predictors</term>
<term>Infarction</term>
<term>Inotropic drugs</term>
<term>Ischemic</term>
<term>Ischemic events</term>
<term>Jacc cardiovasc interv</term>
<term>Lecture fees</term>
<term>Macce</term>
<term>Medical records</term>
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<term>Multivariable analyses</term>
<term>Multivessel disease</term>
<term>Myocardial infarction</term>
<term>Ongoing stemi</term>
<term>Online issue</term>
<term>Other centers</term>
<term>Percutaneous</term>
<term>Predictor</term>
<term>Present study</term>
<term>Primary percutaneous</term>
<term>Prognosis</term>
<term>Radial</term>
<term>Radial access</term>
<term>Radial approach</term>
<term>Randomized</term>
<term>Randomized trials</term>
<term>Receptor blocker</term>
<term>Recurrent ischemia</term>
<term>Research grants</term>
<term>Respiratory support</term>
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<term>Stemi</term>
<term>Stemi patients</term>
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<term>Syndrome</term>
<term>Systematic overview</term>
<term>Tandem heart</term>
<term>Timi</term>
<term>Timi scale</term>
<term>Transfusion</term>
<term>Troponin</term>
<term>Unadjusted survival curves</term>
<term>Unfractionated heparin</term>
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<front><div type="abstract" xml:lang="en">Objectives: We evaluated the incidence, types, and prognostic impact of bleeding complications in a non‐selected patient population with ongoing STEMI treated with aggressive antithrombotic treatment and routine radial primary PCI. Background: Bleeding complications remain frequent and deleterious in primary PCI through femoral approach. Methods: STEMI patients (n = 671) were evaluated for bleeding complications using a web‐based registry (e‐PARIS). In‐hospital bleeding was adjudicated using the TIMI definition. Results: In this non‐selected, high risk population, 6.1% had cardiogenic shock on admission, 3.9% out‐of‐hospital cardiac arrest. Radial access (88%) was the default strategy as was abciximab (78%). Clopidogrel loading dose ranged from 300 to 900 mg. Pre‐hospital fibrinolysis was rare (7.1%). Hemodynamic support devices (IABP, ECMO, Tandem Heart) were needed in 7.0%. In‐hospital TIMI Major and TIMI Major/minor bleedings occurred in 2.5 and 5.7% of the population, respectively. In‐hospital and 1‐year mortality rates were 5.5 and 8.2%, respectively. Patients with in‐hospital TIMI Major/minor bleeding had a higher 1‐year mortality rate (31.6% vs. 3.8%, P < 0.001). The most frequent bleeding site was gastro‐intestinal. Radial access was a strong predictor of survival (OR 0.33; 95%CI 0.17–0.56; P = 0.002). Conclusions: In the setting of radial primary PCI, the rates and types of bleeding complications are somewhat different from those observed with femoral primary PCI. The gastro‐intestinal tract has become the most frequent site of bleeding after radial primary PCI. The use of radial access appears independently associated with survival. © 2011 Wiley Periodicals, Inc</div>
</front>
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<li>France</li>
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<region><li>Nouvelle-Galles du Sud</li>
<li>Île-de-France</li>
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<settlement><li>Paris</li>
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<tree><country name="France"><region name="Île-de-France"><name sortKey="Barthelemy, Olivier" sort="Barthelemy, Olivier" uniqKey="Barthelemy O" first="Olivier" last="Barthélémy">Olivier Barthélémy</name>
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<name sortKey="Bellemain Ppaix, Anne" sort="Bellemain Ppaix, Anne" uniqKey="Bellemain Ppaix A" first="Anne" last="Bellemain-Appaix">Anne Bellemain-Appaix</name>
<name sortKey="Beygui, Farzin" sort="Beygui, Farzin" uniqKey="Beygui F" first="Farzin" last="Beygui">Farzin Beygui</name>
<name sortKey="Brieger, David" sort="Brieger, David" uniqKey="Brieger D" first="David" last="Brieger">David Brieger</name>
<name sortKey="Collet, Jean Philippe" sort="Collet, Jean Philippe" uniqKey="Collet J" first="Jean Philippe" last="Collet">Jean Philippe Collet</name>
<name sortKey="Costagliola, Dominique" sort="Costagliola, Dominique" uniqKey="Costagliola D" first="Dominique" last="Costagliola">Dominique Costagliola</name>
<name sortKey="Lancar, Remi" sort="Lancar, Remi" uniqKey="Lancar R" first="Remi" last="Lancar">Remi Lancar</name>
<name sortKey="Mercadier, Anne" sort="Mercadier, Anne" uniqKey="Mercadier A" first="Anne" last="Mercadier">Anne Mercadier</name>
<name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name>
<name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name>
<name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name>
<name sortKey="Silvain, Johanne" sort="Silvain, Johanne" uniqKey="Silvain J" first="Johanne" last="Silvain">Johanne Silvain</name>
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<country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Brieger, David" sort="Brieger, David" uniqKey="Brieger D" first="David" last="Brieger">David Brieger</name>
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Bleeding complications in primary percutaneous coronary intervention of ST‐elevation myocardial infarction in a radial center

Bleeding complications in primary percutaneous coronary intervention of ST‐elevation myocardial infarction in a radial center

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Abstract

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