Post-PCI Bleeding Linked to Increased In-Hospital Mortality
(HealthDay News) – Post-percutaneous coronary intervention (PCI) bleeding events are associated with an increased risk of in-hospital mortality, according to a study published in the March 13 issue of the Journal of the American Medical Association.
Adnan K. Chhatriwalla, MD, from Saint Luke's Mid America Heart Institute in Kansas City, MO, and colleagues analyzed data from 3,386,688 PCI procedures in the CathPCI Registry performed in the United States between 2004 and 2011. Propensity-matched analysis was conducted to calculate the number needed to harm (NNH) for bleeding-related mortality.
The researchers found that, in total, there were 57,246 bleeding events (1.7%) and 22,165 in-hospital deaths (0.65%). For mortality related to major bleeding, the adjusted population attributable risk was 12.1% in the entire CathPCI cohort. Within the propensity-matched population comprising 56,078 procedures with a major bleeding event and 224,312 controls, major bleeding correlated with increased in-hospital mortality (5.26% vs. 1.87%; NNH, 29). The correlation was observed in all strata of preprocedural bleeding risk (low: 1.62% vs. 0.17%; NNH, 69; intermediate: 3.27% vs. 0.71%; NNH, 39; and high: 8.16% vs. 3.45%; NNH, 21). The NNH was lower for nonaccess site bleeding, although both access-site (2.73% vs. 1.87%; NNH, 117) and nonaccess-site bleeding (8.25% vs. 1.87%; NNH, 16) were associated with increased in-hospital mortality.
"In a large registry of patients undergoing PCI, postprocedural bleeding events were associated with increased risk of in-hospital mortality, with an estimated 12.1% of deaths related to bleeding complications," write the authors.
Several authors disclosed financial ties to the pharmaceutical industry.