Abstract 11004: The NCDR Bleeding Risk Calculator Predicts Mortality
INTRO: Bleeding after percutaneous coronary intervention (PCI) is associated with adverse outcomes. The National Cardiovascular Data Registry (NCDR) developed and validated a bleeding risk score based on clinical variables. However, whether the NCDR bleeding risk calculator also predicts longer-term, 6-month mortality after PCI is not known.
METHODS: Patients undergoing PCI at four University of Pittsburgh Medical Center affiliated hospitals were enrolled in a hospital-based registry and followed prospectively beginning in October 2011. Patient characteristics, in-hospital events, and 6 month follow up were recorded prospectively. The NCDR bleeding risk calculator which is based on 10 clinical variables was used to calculate a bleeding risk score and bleeding events defined by NCDR criteria.
RESULTS: Among 2178 consecutive PCI patients, the average age was 65.3 years, 68.6% were male, 91.9% Caucasian and indication for PCI was STEMI in 21.8%, unstable angina/NSTEMI in 44.9% and stable angina in 33.3%. Patients were categorized by their calculated bleeding risk score with 21% grouped as low (<7 points), 52% as moderate (8-17 points) and 27% as high (>18 points). In-hospital bleeding events by bleeding risk score groups were 1.52, 1.94 and 6.3% respectively (p = 0.0001) with an overall bleeding rate of 3.0%. The Figure 1 illustrates a Kaplan Meier curve for mortality stratified by bleeding risk score groups and demonstrates that the NCDR bleeding risk score is assocaited with 6 month mortality. After adjusting for important covariates, a high bleeding score was associated with a 2 -fold higher risk for death at 6 months (hazard ratio= 2.16 (95% CI 1.17-4.00 p=0.01) compared to the low bleeding risk group.
CONCLUSION: The NCDR bleeding risk calculator not only predicts which patients are at higher risk for in-hospital bleeding events after PCI but also predicts which patients are at higher risk of death for at least 6 months post-PCI.
- © 2013 by American Heart Association, Inc.