Abstract 16404: Bleeding After Discharge Following Hospitalization for Acute Myocardial Infarction
Background: Bleeding is a common complication in hospitalized patients with an acute myocardial infarction (AMI). The frequency of bleeding, particularly less severe bleeding and bruising, after discharge following hospitalization for AMI, its relationship to in-hospital bleeding, and whether similar factors predict its occurrence, have not been defined.
Methods: We analyzed the frequency of bleeding events after discharge among patients hospitalized in the prospective, multicenter TRIUMPH registry. Patients hospitalized with AMI were enrolled at 24 hospitals and underwent in-person or phone interview ascertainment of bleeding at 1 month, with follow-up continued through 1 year post-discharge.
Results: 2940 patients completed the 1-month interview, in which 254 patients (8.6%) reported “easy or significant” bleeding and 5 (0.2%) reported serious bleeding. Easy bruising was reported by 743 patients (25.3%), and 92 patients (3.1%) reported nose or gum bleeding. The occurrence of in-hospital bleeding did not predict a higher rate of post-discharge bleeding. Among 248 patients who had preceding in-hospital severe (TIMI major or minor) bleeding, none had serious bleeding after discharge; of 65 who had in-hospital bleeding classified as major bleeding, only 1 (1.5%) had “easy or significant” bleeding after discharge. 96% of post-discharge bleeding was reported by patients with no or minimal preceding in-hospital bleeding. Baseline CRUSADE bleeding score at initial hospitalization did not predict bleeding after discharge.
Conclusions: Nearly 1 in 10 patients reported “easy or significant” bleeding within 1 month of discharge after hospitalization for AMI and 1 in 4 reported easy bruising, but serious bleeding was rare. The rate of post-discharge bleeding was not higher among patients with in-hospital bleeding. The potential effect of post-discharge bleeding on medication adherence and outcome requires further study.
- © 2011 by American Heart Association, Inc.