Olier, I, Carr, M, Curzen, N, Ludman, P, Baumbach, A, Kinnaird, T, de Belder, MA, Hildick-Smith, D, Sirker, A, Kwok, CS, Rashid, M, Nolan, J, Kontopantelis, E and Mamas, MA ORCID: 0000-0001-9241-8890 (2018) Changes in Peri-procedural Bleeding Complications Following Percutaneous Coronary Intervention in The United Kingdom Between 2006-2013 (From the British Cardiovascular Interventional Society). American Journal of Cardiology. ISSN 1879-1913

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Abstract

Major bleeding is a common complication following percutaneous coronary intervention (PCI), although little is known about how bleeding rates have changed over time and what has driven this. We analyzed all patients undergoing PCI in England and Wales from 2006 to 2013. Multivariate analyses using logistic regression models were performed to identify predictors of bleeding in order to identify potential factors influencing bleeding trends over time. 545,604 participants who had PCI in England and Wales between 2006 and 2013 were included in the analyses. Overall bleeding rates declined from 7.0 (CI:6.2–7.8) per 1000 procedures in 2006 to 5.5 (CI:4.7–6.2) per 1000 in 2013. Increasing age, female sex, GPIIb/IIIa inhibitor use and circulatory support was independently associated with increased risk of bleeding complications whilst radial access and vascular closure device use were independently associated with decreases in risk. Decreases in bleeding rates over time were associated with radial access site, and changes in pharmacology, but this was offset by greater proportion of ACS cases and more the adverse patient clinical demographics. In conclusion, Major bleeding complications after PCI has declined due to changes in access site practice and decreased usage of GPIIb/IIIa inhibitors, but this is offset by the increase of patients with higher propensity to bleed. Changes in access site practice nationally have the potential to significantly reduce major bleeding following PCI.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://www.journals.elsevier.com/the-american-journal-of-cardiology. Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: percutaneous coronary intervention, bleeding, trends
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 06 Jul 2018 08:59
Last Modified: 10 Jul 2018 08:51
URI: http://eprints.keele.ac.uk/id/eprint/4989

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