Bleeding risk high for percutaneous coronary intervention patients

Patients undergoing percutaneous coronary intervention (PCI) are generally at risk of bleeding complications, which prolonged courses of dual antiplatelet therapy (DAPT) could aggravate, a recent study has found.

The study included 7,499 PCI patients, of whom 3,550 had high-bleeding-risk (HBR) features, such as old age, anticoagulation use at discharge, and a prior history of stroke, among other such factors. The remaining 3,949 patients had low-bleeding-risk (LBR) features. In-hospital and follow-up complications, such as major bleeding and death, were the study outcomes.

At baseline, the DAPT score was significantly higher in the HBR patients than in their LBR counterparts (3.7±1.4 vs 2.96±1.1; p<0.001).

Comparing both risk groups, researchers found that the likelihood of vascular complications (3.1 percent vs 1.5 percent; p<0.001) and needing transfusions (5 percent vs 1.6 percent; p<0.001) while admitted were both significantly higher in the HBR group.

During follow-up, the risk of 30-day major bleeding (1.4 percent vs 0.5 percent; p=0.001), and of 6-month death (1.9 percent vs 0.2 percent), major bleeding (6.3 percent vs 2.1 percent; p<0.001 for both), and target lesion revascularization (3.2 percent vs 2.2 percent; p=0.008) were all significantly higher in HBR patients.

The same was true for death and major bleeding at the 12-month (4.4 percent vs 0.6 percent and 10.3 percent vs 4.2 percent, respectively; p<0.001 for both) and 24-month (10 percent vs 1.7 percent and 16.4 percent and 7.1 percent, respectively; p<0.001 for both) follow-ups.