Association between perioperative bleeding post percutaneous coronary intervention and 1 year clinical outcomes in elderly patients

Objective To evaluate the association between perioperative bleeding post percutaneous coronary intervention (PCI) and 1 year adverse cardiovascular events in elderly patients. Methods From June 2006 to August 2011, 1 105 elderly (≥75 years) patients undergoing PCI in Fuwai Hospital were prospectively included. Patients were divided into peri-procedure bleeding group (n=153) and no bleeding group (n=952). Cox proportional hazards model was performed to evaluate the independent effect of bleeding on the composite endpoint of death and myocardial infarction. Results BARC 2 grade bleeding occurred in 9.5% (105/1 105) patients. The rate of BARC≥2 grade bleeding was 11.8% (130/1 105), and the access site-related bleeding accounted for 62.7% (96/153) of all bleeding. The composite endpoint of 1 year death and myocardial infarction was higher in bleeding group (9.2% (14/153) vs. 4.2% (40/952), P=0.008). The 1 year cardiac death was higher in bleeding group (3.9% (6/153) vs. 0.8% (8/952), P=0.007), but the rate of non-cardiac death was similar between bleeding group and no bleeding group (P=0.360). Cox proportional hazards model analysis showed that HR of 1 year death and myocardial infarction in BARC≥2 grade bleeding patients was 2.368 (95%CI:1.201-4.669, P=0.013) compared with no bleeding patients. Conclusion Perioperative bleeding post PCI is an independent predictor of 1 year adverse outcomes in elderly patients (≥75 years). Key words: Angioplasty, transluminal, percutaneous coronary; Hemorrhage; Prognosis; Aged