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EuroIntervention ; 10(1): 83-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24694461

RESUMO

AIMS: The aim of this study was to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients with type 2 diabetes. METHODS AND RESULTS: This study included 4,329 diabetic patients who underwent PCI. Bleeding was assessed using the Bleeding Academic Research Consortium criteria. The primary outcome was one-year mortality. Bleeding events occurred in 474 patients (10.9%). Access-site and non-access-site bleeds occurred in 274 patients (58%) and 200 patients (42%), respectively. Within the first year after PCI there were 198 deaths: 45 deaths (9.6%) among patients with bleeding and 153 deaths (4.0%) among patients without bleeding (adjusted hazard ratio=2.04 [95% confidence interval 1.38-3.00], p<0.001). There were 25 deaths (12.7%) among patients with non-access-site bleeding and 20 deaths (7.4%) among patients with access-site bleeding (odds ratio [OR]=3.45 [2.20-5.41], p<0.001 for non-access-site bleeding vs. no bleeding and OR=1.90 [1.17-3.01], p=0.008 for access-site bleeding vs. no bleeding). Bleeding improved the discriminatory power of the multivariable model for mortality prediction (p=0.002). CONCLUSIONS: In patients with diabetes undergoing PCI, occurrence of bleeding within the first 30 days after PCI was associated with a significant increase in the risk of one-year mortality.


Assuntos
Anticoagulantes/efeitos adversos , Antitrombinas/efeitos adversos , Doença da Artéria Coronariana/terapia , Diabetes Mellitus Tipo 2/complicações , Hemorragia/induzido quimicamente , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária/efeitos adversos , Stents , Abciximab , Idoso , Anticorpos Monoclonais/efeitos adversos , Aspirina/efeitos adversos , Clopidogrel , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/mortalidade , Feminino , Hemorragia/mortalidade , Heparina/efeitos adversos , Hirudinas/efeitos adversos , Humanos , Fragmentos Fab das Imunoglobulinas/efeitos adversos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/efeitos adversos , Prognóstico , Modelos de Riscos Proporcionais , Proteínas Recombinantes/efeitos adversos , Fatores de Risco , Ticlopidina/efeitos adversos , Ticlopidina/análogos & derivados
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