Abstract 18502: Bleeding Post PCI: Predictors of “ANY” Bleeds: Six Month Results from the PARIS (Patterns of Non-Adherence to Antiplatelet Regimens in Stented Patients) Registry
Introduction. While recent studies have highlighted the clinical importance of minor, or “nuisance” bleeding, the predictors of all bleeding complications including minor bleeding events have not been examined in detail.
Methods. The PARIS registry was a multicenter, international, all-comers registry of patients who had undergone successful PCI in 2009-2010 for stable angina, acute coronary syndrome (ACS) or documented silent ischemia. All bleeding events were adjudicated by a Clinical Events Committee according to the Bleeding Academic Research Consortium (BARC) criteria from source documents. We compared baseline clinical and treatment variables in patients who had any versus no bleeding at 6-months.
Results. Of 5,033 patients, 235 (4.7%) had a bleeding event in the first 6-months. Of these, 27.7% had BARC type 1 bleeding, 40.4% had BARC type 2 bleeding, 30.2% had type 3, 0.4% had type 4 (CABG-related), and 1.3% had type 5 (fatal) bleeding. Compared to patients with no bleeding, patients who had bleeding were more likely to be older, female, non-smokers, and to be prescribed on warfarin on discharge (Table). After multivariable analysis, independent predictors of 6-month bleeding were age (OR 1.02, 95% CI 1.002 - 1.03), female gender (OR 1.9, 95% CI 1.3 - 2.9), and warfarin therapy (OR 2.6, 95% CI 1.7 - 3.7, all p<0.05), whereas hypertension was associated with reduced risk of bleeding (OR 0.7, 95% CI 0.52 - 0.98, p=0.04). Treatment with prasugrel (vs. clopidogrel) was not a predictor.
Conclusion. In this real world, contemporary PCI registry with close evaluation of bleeding events, the 6-month rate of any bleeding was 4.7%. Almost 70% of these bleeding incidents were BARC type 1 and 2, which may be classified as minor or “nuisance” bleeds. Age, female gender, and warfarin were independent predictors of bleeding events. Table.
- © 2012 by American Heart Association, Inc.