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Dokumenttyp:
journal article 
Autor(en):
Ndrepepa, Gjin; Neumann, Franz-Josef; Schulz, Stefanie; Fusaro, Massimiliano; Cassese, Salvatore; Byrne, Robert A; Richardt, Gert; Laugwitz, Karl-Ludwig; Kastrati, Adnan 
Titel:
Incidence and prognostic value of bleeding after percutaneous coronary intervention in patients older than 75 years of age. 
Abstract:
We aimed to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients>75 years of age.Limited information exists on the impact of post-PCI bleeding on the outcome in elderly patients.This study included 3,255 patients>75 years of age. Bleeding events were assessed using the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 1-year mortality.Within 30 days after PCI, bleeding occurred in 501 patients (15.4%). Bleeding according to BARC was: class 1 (170 patients; 33.9%), class 2 (81 patients; 16.2%), class 3a (177 patients; 35.3%), class 3b (65 patients; 13.0%), class 3c (four patients; 0.8%), and class 4 (four patients; 0.8%). There were 201 deaths within the first year after PCI: 61 deaths (12.3%) among bleeders and 140 deaths (5.1%) among nonbleeders (adjusted hazard ratio = 2.03, 95% confidence interval [CI] 1.42-2.91, P< 0.001). Bleeding improved the discriminatory power of multivariable model for mortality prediction (P = 0.001). Female sex (adjusted odds ratio [OR] = 1.49 [1.17-1.88], P = 0.001) and reduced renal function (adjusted OR = 1.30 [1.04-1.63], P = 0.019 for each 30 ml/min decrease in the creatinine clearance) were independent associates of increased bleeding risk. Bivalirudin reduced the bleeding risk by 24% compared with unfractionated heparin and 33% compared with abciximab plus unfractionated heparin.Post-PCI bleeding is an important prognostic factor in patients>75 years of age. The risk for bleeding in this age category is increased in women and patients with impaired renal function. Bleeding risk is reduced by bivalirudin. 
Zeitschriftentitel:
Catheter Cardiovasc Interv 
Jahr:
2014 
Band / Volume:
83 
Heft / Issue:
Seitenangaben Beitrag:
182-9 
Sprache:
eng 
Print-ISSN:
1522-1946 
TUM Einrichtung:
Klinik für Herz- und Kreislauferkrankungen; I. Medizinische Klinik und Poliklinik