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Impact of in‐hospital bleeding according to the bleeding academic research consortium classification on the long‐term adverse outcomes in patients undergoing percutaneous coronary intervention
Author(s) -
Yoon YongHoon,
Kim YoungHak,
Kim SeonOk,
Lee JongYoung,
Park DukWoo,
Kang SooJin,
Lee SeungWhan,
Lee Cheol Whan,
Park SeongWook,
Park SeungJung
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25308
Subject(s) - medicine , percutaneous coronary intervention , adverse effect , term (time) , major bleeding , cardiology , myocardial infarction , physics , quantum mechanics
Objectives The aim of this study was to assess the impact of bleeding after percutaneous coronary intervention (PCI) with drug‐eluting stents on long‐term clinical events according to the newly proposed Bleeding Academic Research Consortium (BARC) classification. Background Current evidence about the impact of the BARC classification is limited. Methods Out of a total of 6,166 patients who underwent PCI in a prospective IRIS‐DES registry, the impact of in‐hospital bleeding defined as the BARC classification on major adverse cardiovascular events (MACE) comprising death, myocardial infarction (MI), or stroke was analyzed. Results In‐hospital bleeding occurred in 235 patients (3.8%) according to BARC classification. During the 2‐year follow‐up, MACE occurred in 599 patients (9.7%). The 2‐year incidence of MACE was significantly higher in patients with bleeding (16.7% vs. 8.3%; adjusted hazard ratio [HR], 1.6; 95% confidence interval [CI], 1.2–2.3; P = 0.002) than in those without bleeding. We observed a higher risk of MI (12.4% vs. 6.4%; adjusted HR, 1.7; 95% CI, 1.2–2.6, P = 0.005), stroke (3.0% vs. 0.6%; adjusted HR, 2.9; 95% CI, 1.4–6.2, P = 0.005) in patients with bleeding. Death (3.8% vs. 1.6%; adjusted HR, 1.6; 95% CI, 0.9–3.0, P = 0.120) and target vessel revascularization (4.3% vs. 1.9%; adjusted HR, 1.6; 95% CI, 0.9–2.9, P = 0.108) were statistically insignificant. Incidence, adjusted HR and P ‐value were similar between BARC and TIMI classification. Conclusions In‐hospital bleeding events according to the newly proposed BARC definition were significantly associated with an increased risk of adverse long‐term events in patients undergoing PCI with drug‐eluting stents. © 2014 Wiley Periodicals, Inc.