Background: Little is known about the impact of bleeding site on mortality after percutaneous coronary intervention. The aim of this study was to assess the impact of access and non-access site bleeding within 30 days after percutaneous coronary intervention on mortality.
Methods And Results: This study represents a pooled patient-level analysis of 14 180 patients recruited in 7 randomized trials. Access and non-access site bleeding were assessed using the Bleeding Academic Research Consortium criteria. The primary outcome was 1-year mortality. Follow-up was complete in 97.5% of the patients. There were 414 deaths within the first year after percutaneous coronary intervention: 44 deaths among patients with access site bleeding, 60 deaths among patients with non-access site bleeding, and 310 deaths among patients without bleeding (Kaplan-Meier estimates of mortality, 4.5%, 10.0%, and 2.5%, respectively; adjusted hazard ratio, 1.72 [95% confidence interval, 1.19-2.47] for access site bleeding versus no bleeding; hazard ratio, 2.78 [2.00-3.86] for non-access site versus no bleeding). The inclusion of non-access site bleeding (the absolute and relative integrated discrimination improvement, 0.005 and 8.9%; P=0.031) but not of access site bleeding (the absolute and relative integrated discrimination improvement, 0.0015 and 2.7%; P=0.084) was associated with an improvement of the discriminatory power of multivariable model for mortality prediction.
Conclusions: Both access and non-access site bleeding events occurring within 30 days of a percutaneous coronary intervention are independently associated with an increased risk of 1-year mortality. Non-access site bleeding is a stronger correlate of mortality than access site bleeding, and it improves the discriminatory power of models for mortality prediction.
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http://dx.doi.org/10.1161/CIRCINTERVENTIONS.113.000433 | DOI Listing |
Medicina (Kaunas)
December 2024
Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu Street 2, 50161 Kaunas, Lithuania.
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View Article and Find Full Text PDFCureus
December 2024
Medicine, Yangtze University, Jingzhou, CHN.
This study aimed to assess the results of reconstructive surgery with vacuum-assisted closure (VAC) therapy in patients with complex wounds. The sample included 60 patients with a mean age of 53.03 years.
View Article and Find Full Text PDFElectromagn Biol Med
January 2025
Department of Mathematics, University of Gour Banga, Malda, India.
Biomagnetic fluid dynamics (BFD) is an emerging and promising field within fluid mechanics, focusing on the dynamics of bio-fluids like blood in the presence of magnetic fields. This research is crucial in the medical arena for applications such as medication delivery, diagnostic and therapeutic procedures, prevention of excessive bleeding, and treatment of malignant tumors using magnetic particles. This study delves into the intricacies of blood flow induced by cilia, carrying trihybrid nanoparticles (gold, copper, and titania), within a catheterized arterial annulus under a robust magnetic field.
View Article and Find Full Text PDFJ Am Heart Assoc
January 2025
Department of Neurology with experimental Neurology (Klinik und Hochschulambulanz für Neurologie mit experimenteller Neurologie), Charité-Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin Berlin Germany.
Front Cardiovasc Med
January 2025
Department of Cardiovascular Surgery, Gaozhou People's Hospital, Gaozhou, Guangdong, China.
Objective: The objective of this study was to improve long-term postoperative survival in a porcine cardiac valve surgery model by utilizing cardiopulmonary bypass (CPB) via left thoracotomy. The study aimed to share refined techniques and insights accumulated over years at a single-center animal clinical trial facility.
Method: A total of 196 Chinese Large White pigs weighing between 60 and 75 kg were used in the study.
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