Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach
Aims Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach. Methods and results Baseline clinical and procedural variables fro...
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| Veröffentlicht in: | European heart journal 2007-08, Vol.28 (16), p.1936-1945 |
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| container_issue | 16 |
| container_start_page | 1936 |
| container_title | European heart journal |
| container_volume | 28 |
| creator | Nikolsky, Eugenia Mehran, Roxana Dangas, George Fahy, Martin Na, Yingbo Pocock, Stuart J. Lincoff, A. Michael Stone, Gregg W. |
| description | Aims Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach. Methods and results Baseline clinical and procedural variables from two contemporary, multicentre, randomized PCI trials were used for risk score development (the REPLACE-2 trial, n = 6002) and validation (the REPLACE-1 trial, n = 1056). On the basis of the odds ratio, independent risk factors were assigned a weighted integer, the sum of which comprised a total risk score. Seven variables were identified as independent correlates of major bleeding (age >55 years, female gender, estimated glomerular filtration rate |
| doi_str_mv | 10.1093/eurheartj/ehm194 |
| format | Article |
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Michael ; Stone, Gregg W.</creator><creatorcontrib>Nikolsky, Eugenia ; Mehran, Roxana ; Dangas, George ; Fahy, Martin ; Na, Yingbo ; Pocock, Stuart J. ; Lincoff, A. Michael ; Stone, Gregg W.</creatorcontrib><description>Aims Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach. Methods and results Baseline clinical and procedural variables from two contemporary, multicentre, randomized PCI trials were used for risk score development (the REPLACE-2 trial, n = 6002) and validation (the REPLACE-1 trial, n = 1056). On the basis of the odds ratio, independent risk factors were assigned a weighted integer, the sum of which comprised a total risk score. Seven variables were identified as independent correlates of major bleeding (age >55 years, female gender, estimated glomerular filtration rate <60 mL/min/1.73 m2, pre-existing anaemia, administration of low-molecular-weight heparin within 48 h pre-PCI, use of glycoprotein IIb/IIIa inhibitors, and intraaortic balloon pump use). In the development set, the risk of major bleeding varied from 1.0% in patients without risk factors to 5.4% in high-risk patients. The discriminatory power of this risk model was confirmed in the validation data set (area under the receiver operating curve = 0.62). Conclusion A simple risk score of baseline clinical and procedural variables is useful to predict the incidence of major peri-procedural bleeding after contemporary PCI using the femoral approach.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehm194</identifier><identifier>PMID: 17575270</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Age Factors ; Aged ; Anemia - complications ; Angioplasty ; Angioplasty, Balloon, Coronary - adverse effects ; Anticoagulants - adverse effects ; Body Weight ; Female ; Humans ; Major bleeding ; Male ; Middle Aged ; Postoperative Hemorrhage - etiology ; Prognosis ; Renal Insufficiency - complications ; Risk Assessment ; Risk Factors ; Risk score ; Sex Factors ; Whole Blood Coagulation Time</subject><ispartof>European heart journal, 2007-08, Vol.28 (16), p.1936-1945</ispartof><rights>The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2007</rights><rights>The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c506t-61bfe6116f23f2c10930ec43514b620151cd686a9d11de9c450ad673eefb706f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17575270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nikolsky, Eugenia</creatorcontrib><creatorcontrib>Mehran, Roxana</creatorcontrib><creatorcontrib>Dangas, George</creatorcontrib><creatorcontrib>Fahy, Martin</creatorcontrib><creatorcontrib>Na, Yingbo</creatorcontrib><creatorcontrib>Pocock, Stuart J.</creatorcontrib><creatorcontrib>Lincoff, A. Michael</creatorcontrib><creatorcontrib>Stone, Gregg W.</creatorcontrib><title>Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach. Methods and results Baseline clinical and procedural variables from two contemporary, multicentre, randomized PCI trials were used for risk score development (the REPLACE-2 trial, n = 6002) and validation (the REPLACE-1 trial, n = 1056). On the basis of the odds ratio, independent risk factors were assigned a weighted integer, the sum of which comprised a total risk score. Seven variables were identified as independent correlates of major bleeding (age >55 years, female gender, estimated glomerular filtration rate <60 mL/min/1.73 m2, pre-existing anaemia, administration of low-molecular-weight heparin within 48 h pre-PCI, use of glycoprotein IIb/IIIa inhibitors, and intraaortic balloon pump use). In the development set, the risk of major bleeding varied from 1.0% in patients without risk factors to 5.4% in high-risk patients. The discriminatory power of this risk model was confirmed in the validation data set (area under the receiver operating curve = 0.62). Conclusion A simple risk score of baseline clinical and procedural variables is useful to predict the incidence of major peri-procedural bleeding after contemporary PCI using the femoral approach.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Anemia - complications</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Anticoagulants - adverse effects</subject><subject>Body Weight</subject><subject>Female</subject><subject>Humans</subject><subject>Major bleeding</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Prognosis</subject><subject>Renal Insufficiency - complications</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk score</subject><subject>Sex Factors</subject><subject>Whole Blood Coagulation Time</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkctu1DAUhi1ERYfCnhWyWLBBaX2S2EmWaKAUqVIXXDRiYznOyYyniR1sZwTPwsviUUatxIqNLVnffzk-hLwCdgmsKa5w9jtUPu6vcDdCUz4hK-B5njWi5E_JikHDMyHqzTl5HsKeMVYLEM_IOVS84nnFVuTPBzzg4KYRbaTKdvSgBtOpaJylrqeKTt5trQvRaOpNuKdBO4-0d56Oap_OdkDsjN1SY-mUdMkn0Nl26Lfu-Dyh13NUFt0caNI6q_zvBEf0h8Qecw5G0bhLpjg6rwaqphSq9O4FOevVEPDl6b4g364_fl3fZLd3nz6v399mmjMRMwFtjwJA9HnR5_r4MQx1WXAoW5Ez4KA7UQvVdAAdNrrkTHWiKhD7tmKiLy7I28U3xf6cMUQ5mqBxGJbWUtQgqrLhCXzzD7h3s7epm8yBc-BNUSeILZD2LgSPvZy8GdPQEpg8lpMPW5PL1pLk9cl3bkfsHgWnNSXg3QK4efofu2yhTYj464FX_l6msSsubzY_5Kb4Xl4X4otcF38B5n642A</recordid><startdate>20070801</startdate><enddate>20070801</enddate><creator>Nikolsky, Eugenia</creator><creator>Mehran, Roxana</creator><creator>Dangas, George</creator><creator>Fahy, Martin</creator><creator>Na, Yingbo</creator><creator>Pocock, Stuart J.</creator><creator>Lincoff, A. Michael</creator><creator>Stone, Gregg W.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20070801</creationdate><title>Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach</title><author>Nikolsky, Eugenia ; Mehran, Roxana ; Dangas, George ; Fahy, Martin ; Na, Yingbo ; Pocock, Stuart J. ; Lincoff, A. Michael ; Stone, Gregg W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c506t-61bfe6116f23f2c10930ec43514b620151cd686a9d11de9c450ad673eefb706f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Anemia - complications</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Anticoagulants - adverse effects</topic><topic>Body Weight</topic><topic>Female</topic><topic>Humans</topic><topic>Major bleeding</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Prognosis</topic><topic>Renal Insufficiency - complications</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk score</topic><topic>Sex Factors</topic><topic>Whole Blood Coagulation Time</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nikolsky, Eugenia</creatorcontrib><creatorcontrib>Mehran, Roxana</creatorcontrib><creatorcontrib>Dangas, George</creatorcontrib><creatorcontrib>Fahy, Martin</creatorcontrib><creatorcontrib>Na, Yingbo</creatorcontrib><creatorcontrib>Pocock, Stuart J.</creatorcontrib><creatorcontrib>Lincoff, A. Michael</creatorcontrib><creatorcontrib>Stone, Gregg W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nikolsky, Eugenia</au><au>Mehran, Roxana</au><au>Dangas, George</au><au>Fahy, Martin</au><au>Na, Yingbo</au><au>Pocock, Stuart J.</au><au>Lincoff, A. Michael</au><au>Stone, Gregg W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2007-08-01</date><risdate>2007</risdate><volume>28</volume><issue>16</issue><spage>1936</spage><epage>1945</epage><pages>1936-1945</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aims Major bleeding after percutaneous coronary intervention (PCI) is an independent risk factor for early and late mortality. We developed and validated a risk score predictive of major bleeding after PCI using the femoral approach. Methods and results Baseline clinical and procedural variables from two contemporary, multicentre, randomized PCI trials were used for risk score development (the REPLACE-2 trial, n = 6002) and validation (the REPLACE-1 trial, n = 1056). On the basis of the odds ratio, independent risk factors were assigned a weighted integer, the sum of which comprised a total risk score. Seven variables were identified as independent correlates of major bleeding (age >55 years, female gender, estimated glomerular filtration rate <60 mL/min/1.73 m2, pre-existing anaemia, administration of low-molecular-weight heparin within 48 h pre-PCI, use of glycoprotein IIb/IIIa inhibitors, and intraaortic balloon pump use). In the development set, the risk of major bleeding varied from 1.0% in patients without risk factors to 5.4% in high-risk patients. The discriminatory power of this risk model was confirmed in the validation data set (area under the receiver operating curve = 0.62). Conclusion A simple risk score of baseline clinical and procedural variables is useful to predict the incidence of major peri-procedural bleeding after contemporary PCI using the femoral approach.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>17575270</pmid><doi>10.1093/eurheartj/ehm194</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Age Factors Aged Anemia - complications Angioplasty Angioplasty, Balloon, Coronary - adverse effects Anticoagulants - adverse effects Body Weight Female Humans Major bleeding Male Middle Aged Postoperative Hemorrhage - etiology Prognosis Renal Insufficiency - complications Risk Assessment Risk Factors Risk score Sex Factors Whole Blood Coagulation Time |
| title | Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach |
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