Healio
Healio
May 15, 2014
1 min read
Save

Non-access site bleeding associated with increased mortality in STEMI

One-year mortality was increased nearly threefold in a cohort of patients with non-access site bleeding after PCI in patients with STEMI.

The researchers aimed to evaluate whether access site bleeding or non-access site bleeding can predict outcomes in STEMI. The analysis included 2,002 patients who underwent primary PCI. The study also included a meta-analysis of studies investigating access site bleeding status in patients undergoing primary PCI for STEMI.

Outcome measures included 1-year mortality, recurrent MI, stent thrombosis and stroke.

Radial access was used in 3.7% of patients.

The rate of access site bleeding was 6.3%, while the rate of non-access site bleeding was 5.2%.

Multivariate analysis indicated no association between access site bleeding and 1-year mortality risk (HR=1.03; P=.89). Recurrent MI (HR=1.16; P=.64), stent thrombosis (HR=0.55; P=.42) and stroke (HR=0.47; P=.31) also demonstrated no association with access site bleeding.

However, an independent association between non-access site bleeding and 1-year mortality was reported (HR=2.77; P<.001). Non-access site bleeding was also associated with stent thrombosis (HR=3.10; P=.021), but not with recurrent MI or stroke.

In addition, a meta-analysis of 495,630 patients indicated a higher risk of 1-year mortality among those who experienced non-access site bleeding (HR=1.66; 95% CI, 1.56-1.76) compared with access site bleeding (HR=1.21; 95% CI, 1.11-1.31).

“These results taken together with those of previous studies indicate a greater risk of subsequent mortality in patients with non-[access site bleeding],” the researchers concluded.

Disclosure: The researchers report financial disclosures with Abbott Vascular, AstraZeneca, Boston Scientific, Covidien, CSL Behring, Eli Lilly/Daiichi Sankyo, Endothelix, Janssen Pharmaceuticals, Maya Medical, Merck & Co., Regado Biosciences, Sanofi Aventis and The Medicines Company.

Sources/Disclosures

Collapse
Source: Kikkert WJ. J Am Coll Cardiol Intv. 2014;doi:10.1016/ j.jcin.2014.01.162.