Relation of Bleeding Events to Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated by Percutaneous Coronary Intervention (a DANAMI-3 Substudy)
Bleeding events in relation to treatment of ST-segment elevation myocardial infarction (STEMI) have previously been associated with mortality. In this study, we investigated the incidence and prognosis of, and variables associated with serious bleedings within 30 days after primary percutaneous coro...
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| Veröffentlicht in: | The American journal of cardiology 2018-04, Vol.121 (7), p.781-788 |
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| creator | Sadjadieh, Golnaz Engstrøm, Thomas Helqvist, Steffen Høfsten, Dan Eik Køber, Lars Pedersen, Frants Laursen, Peter Nørkjær Nepper-Christensen, Lars Clemmensen, Peter Møller-Helgestad, Ole Kristian Sørensen, Rikke Ravkilde, Jan Terkelsen, Christian Juhl Jørgensen, Erik Saunamäki, Kari Tilsted, Hans-Henrik Kelbæk, Henning Holmvang, Lene |
| description | Bleeding events in relation to treatment of ST-segment elevation myocardial infarction (STEMI) have previously been associated with mortality. In this study, we investigated the incidence and prognosis of, and variables associated with serious bleedings within 30 days after primary percutaneous coronary intervention in patients from The Third Danish Study of Optimal Acute Treatment of Patients with ST-Segment Elevation Myocardial Infarction (DANAMI-3) (n = 2,217). Hospital charts were read within 30 days postadmission to assess bleeding events using thrombolysis in myocardial infarction (TIMI) and Bleeding Academic Research Consortium criteria. TIMI minor/major bleeding (TMMB) occurred in 59 patients (2.7%). Variables associated with TMMB were female gender (hazard ratio [HR] 3.9, 95% confidence interval [CI] 2.2 to 6.7, p 3 hours (HR 1.9, 95% CI 1.1 to 3.3, p = 0.02), use of glycoprotein IIb/IIIa inhibitor (HR 2.1, 95% CI 1.2 to 3.7, p = 0.01), and increasing S-creatinine (HR 1.1, 95% CI 1.0 to 1.2, p = 0.001). Undergoing 2 in-hospital procedures were not associated with increased risk of TMMB. TMMB was strongly associated with 30-day mortality in multivariable analysis (HR 4.8, 95% CI 2.2 to 10.4, p |
| doi_str_mv | 10.1016/j.amjcard.2017.12.019 |
| format | Article |
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In this study, we investigated the incidence and prognosis of, and variables associated with serious bleedings within 30 days after primary percutaneous coronary intervention in patients from The Third Danish Study of Optimal Acute Treatment of Patients with ST-Segment Elevation Myocardial Infarction (DANAMI-3) (n = 2,217). Hospital charts were read within 30 days postadmission to assess bleeding events using thrombolysis in myocardial infarction (TIMI) and Bleeding Academic Research Consortium criteria. TIMI minor/major bleeding (TMMB) occurred in 59 patients (2.7%). Variables associated with TMMB were female gender (hazard ratio [HR] 3.9, 95% confidence interval [CI] 2.2 to 6.7, p <0.0001), symptom-to-catheterization time >3 hours (HR 1.9, 95% CI 1.1 to 3.3, p = 0.02), use of glycoprotein IIb/IIIa inhibitor (HR 2.1, 95% CI 1.2 to 3.7, p = 0.01), and increasing S-creatinine (HR 1.1, 95% CI 1.0 to 1.2, p = 0.001). Undergoing 2 in-hospital procedures were not associated with increased risk of TMMB. TMMB was strongly associated with 30-day mortality in multivariable analysis (HR 4.8, 95% CI 2.2 to 10.4, p <0.0001) but not with mortality days 31 to 365. When excluding fatal bleedings from the analysis, a TMMB was no longer associated with 30-day mortality. In conclusion, we found that in a contemporary STEMI-population, the incidence of 30-day TMMB was low. A TMMB was strongly associated with 30-day mortality but not with mortality days 31 to 365. If patients survived a serious bleeding, their short- and long-term prognoses were not affected.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2017.12.019</identifier><identifier>PMID: 29402421</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Angioplasty ; Bleeding ; Blood pressure ; Catheterization ; Confidence intervals ; Consortia ; Creatinine ; Diabetes ; Electrocardiography ; Glycoproteins ; Heart attacks ; Heart rate ; Hospitals ; Incidence ; Intervention ; Medical imaging ; Mortality ; Myocardial infarction ; Patients ; Prognosis ; Stents ; Thrombolysis</subject><ispartof>The American journal of cardiology, 2018-04, Vol.121 (7), p.781-788</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><rights>2018. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-8288eadbb3013eda1740bac19fd595482144a74b3095a23473cae071d9474f283</citedby><cites>FETCH-LOGICAL-c393t-8288eadbb3013eda1740bac19fd595482144a74b3095a23473cae071d9474f283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2014372006?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994,64384,64386,64388,72340</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29402421$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sadjadieh, Golnaz</creatorcontrib><creatorcontrib>Engstrøm, Thomas</creatorcontrib><creatorcontrib>Helqvist, Steffen</creatorcontrib><creatorcontrib>Høfsten, Dan Eik</creatorcontrib><creatorcontrib>Køber, Lars</creatorcontrib><creatorcontrib>Pedersen, Frants</creatorcontrib><creatorcontrib>Laursen, Peter Nørkjær</creatorcontrib><creatorcontrib>Nepper-Christensen, Lars</creatorcontrib><creatorcontrib>Clemmensen, Peter</creatorcontrib><creatorcontrib>Møller-Helgestad, Ole Kristian</creatorcontrib><creatorcontrib>Sørensen, Rikke</creatorcontrib><creatorcontrib>Ravkilde, Jan</creatorcontrib><creatorcontrib>Terkelsen, Christian Juhl</creatorcontrib><creatorcontrib>Jørgensen, Erik</creatorcontrib><creatorcontrib>Saunamäki, Kari</creatorcontrib><creatorcontrib>Tilsted, Hans-Henrik</creatorcontrib><creatorcontrib>Kelbæk, Henning</creatorcontrib><creatorcontrib>Holmvang, Lene</creatorcontrib><title>Relation of Bleeding Events to Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated by Percutaneous Coronary Intervention (a DANAMI-3 Substudy)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Bleeding events in relation to treatment of ST-segment elevation myocardial infarction (STEMI) have previously been associated with mortality. In this study, we investigated the incidence and prognosis of, and variables associated with serious bleedings within 30 days after primary percutaneous coronary intervention in patients from The Third Danish Study of Optimal Acute Treatment of Patients with ST-Segment Elevation Myocardial Infarction (DANAMI-3) (n = 2,217). Hospital charts were read within 30 days postadmission to assess bleeding events using thrombolysis in myocardial infarction (TIMI) and Bleeding Academic Research Consortium criteria. TIMI minor/major bleeding (TMMB) occurred in 59 patients (2.7%). Variables associated with TMMB were female gender (hazard ratio [HR] 3.9, 95% confidence interval [CI] 2.2 to 6.7, p <0.0001), symptom-to-catheterization time >3 hours (HR 1.9, 95% CI 1.1 to 3.3, p = 0.02), use of glycoprotein IIb/IIIa inhibitor (HR 2.1, 95% CI 1.2 to 3.7, p = 0.01), and increasing S-creatinine (HR 1.1, 95% CI 1.0 to 1.2, p = 0.001). Undergoing 2 in-hospital procedures were not associated with increased risk of TMMB. TMMB was strongly associated with 30-day mortality in multivariable analysis (HR 4.8, 95% CI 2.2 to 10.4, p <0.0001) but not with mortality days 31 to 365. When excluding fatal bleedings from the analysis, a TMMB was no longer associated with 30-day mortality. In conclusion, we found that in a contemporary STEMI-population, the incidence of 30-day TMMB was low. A TMMB was strongly associated with 30-day mortality but not with mortality days 31 to 365. If patients survived a serious bleeding, their short- and long-term prognoses were not affected.</description><subject>Acute coronary syndromes</subject><subject>Angioplasty</subject><subject>Bleeding</subject><subject>Blood pressure</subject><subject>Catheterization</subject><subject>Confidence intervals</subject><subject>Consortia</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Electrocardiography</subject><subject>Glycoproteins</subject><subject>Heart attacks</subject><subject>Heart rate</subject><subject>Hospitals</subject><subject>Incidence</subject><subject>Intervention</subject><subject>Medical imaging</subject><subject>Mortality</subject><subject>Myocardial 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Peter</au><au>Møller-Helgestad, Ole Kristian</au><au>Sørensen, Rikke</au><au>Ravkilde, Jan</au><au>Terkelsen, Christian Juhl</au><au>Jørgensen, Erik</au><au>Saunamäki, Kari</au><au>Tilsted, Hans-Henrik</au><au>Kelbæk, Henning</au><au>Holmvang, Lene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of Bleeding Events to Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated by Percutaneous Coronary Intervention (a DANAMI-3 Substudy)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>121</volume><issue>7</issue><spage>781</spage><epage>788</epage><pages>781-788</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Bleeding events in relation to treatment of ST-segment elevation myocardial infarction (STEMI) have previously been associated with mortality. In this study, we investigated the incidence and prognosis of, and variables associated with serious bleedings within 30 days after primary percutaneous coronary intervention in patients from The Third Danish Study of Optimal Acute Treatment of Patients with ST-Segment Elevation Myocardial Infarction (DANAMI-3) (n = 2,217). Hospital charts were read within 30 days postadmission to assess bleeding events using thrombolysis in myocardial infarction (TIMI) and Bleeding Academic Research Consortium criteria. TIMI minor/major bleeding (TMMB) occurred in 59 patients (2.7%). Variables associated with TMMB were female gender (hazard ratio [HR] 3.9, 95% confidence interval [CI] 2.2 to 6.7, p <0.0001), symptom-to-catheterization time >3 hours (HR 1.9, 95% CI 1.1 to 3.3, p = 0.02), use of glycoprotein IIb/IIIa inhibitor (HR 2.1, 95% CI 1.2 to 3.7, p = 0.01), and increasing S-creatinine (HR 1.1, 95% CI 1.0 to 1.2, p = 0.001). Undergoing 2 in-hospital procedures were not associated with increased risk of TMMB. TMMB was strongly associated with 30-day mortality in multivariable analysis (HR 4.8, 95% CI 2.2 to 10.4, p <0.0001) but not with mortality days 31 to 365. When excluding fatal bleedings from the analysis, a TMMB was no longer associated with 30-day mortality. In conclusion, we found that in a contemporary STEMI-population, the incidence of 30-day TMMB was low. A TMMB was strongly associated with 30-day mortality but not with mortality days 31 to 365. If patients survived a serious bleeding, their short- and long-term prognoses were not affected.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29402421</pmid><doi>10.1016/j.amjcard.2017.12.019</doi><tpages>8</tpages></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Acute coronary syndromes Angioplasty Bleeding Blood pressure Catheterization Confidence intervals Consortia Creatinine Diabetes Electrocardiography Glycoproteins Heart attacks Heart rate Hospitals Incidence Intervention Medical imaging Mortality Myocardial infarction Patients Prognosis Stents Thrombolysis |
| title | Relation of Bleeding Events to Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated by Percutaneous Coronary Intervention (a DANAMI-3 Substudy) |
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