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Incidence and Predictors of Major Vascular Complications after Percutaneous Coronary Intervention in the Glycoprotein IIb/IIIa Platelet Inhibitor Era

Incidence and Predictors of Major Vascular Complications after Percutaneous Coronary Intervention... Since the introduction of platelet glycoprotein (GP) IIb/IIIa inhibitors, reports of vascular complications after percutaneous coronary intervention (PCI) have focused on bleeding and the need for surgical repair, whereas specific major vascular complications have been less consistently identified. Moreover, data from clinical trials may lack applicability to the general population. The purpose of this study was to determine the incidence of major vascular complications after PCI and to identify associated risk factors in patients routinely receiving GP IIb/IIIa inhibitors. During a 12‐month period, 1,634 consecutive patients underwent PCI at a single institution. Clinical characteristics and procedural data were collected prospectively; data regarding vascular sheath removal were obtained retrospectively. Univariate and multivariable regression methods were used to identify independent predictors of major vascular complications. Major vascular complications occurred in 2.9% of patients. Multivariable analysis revealed advanced age (odds ratio (OR) 1.05, P = 0.0025) and female sex (OR 2.9, P = 0.0002) as clinical characteristics associated with major vascular complications, whereas hypertension had an inverse relationship (OR 0.46, P = 0.013). Procedural factors included use of the following: stents (OR 5.59, P < 0.0001), vascular sheaths >6F (OR 3.25, P = 0.016), and mechanical clamp (OR 2.71, P = 0.0012). The presence of a hematoma >4 cm2 had a positive predictive value of 12% for major vascular complications. The incidence of major vascular complications in this large, single‐center study from the GP IIb/IIIa inhibitor era is consistent with data from the pre‐GP IIb/IIIa inhibitor era and recent randomized trials. (J Interven Cardiol 2004;17:65–70) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Incidence and Predictors of Major Vascular Complications after Percutaneous Coronary Intervention in the Glycoprotein IIb/IIIa Platelet Inhibitor Era

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References (26)

Publisher
Wiley
Copyright
Copyright © 2004 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2004.00295.x
pmid
15104767
Publisher site
See Article on Publisher Site

Abstract

Since the introduction of platelet glycoprotein (GP) IIb/IIIa inhibitors, reports of vascular complications after percutaneous coronary intervention (PCI) have focused on bleeding and the need for surgical repair, whereas specific major vascular complications have been less consistently identified. Moreover, data from clinical trials may lack applicability to the general population. The purpose of this study was to determine the incidence of major vascular complications after PCI and to identify associated risk factors in patients routinely receiving GP IIb/IIIa inhibitors. During a 12‐month period, 1,634 consecutive patients underwent PCI at a single institution. Clinical characteristics and procedural data were collected prospectively; data regarding vascular sheath removal were obtained retrospectively. Univariate and multivariable regression methods were used to identify independent predictors of major vascular complications. Major vascular complications occurred in 2.9% of patients. Multivariable analysis revealed advanced age (odds ratio (OR) 1.05, P = 0.0025) and female sex (OR 2.9, P = 0.0002) as clinical characteristics associated with major vascular complications, whereas hypertension had an inverse relationship (OR 0.46, P = 0.013). Procedural factors included use of the following: stents (OR 5.59, P < 0.0001), vascular sheaths >6F (OR 3.25, P = 0.016), and mechanical clamp (OR 2.71, P = 0.0012). The presence of a hematoma >4 cm2 had a positive predictive value of 12% for major vascular complications. The incidence of major vascular complications in this large, single‐center study from the GP IIb/IIIa inhibitor era is consistent with data from the pre‐GP IIb/IIIa inhibitor era and recent randomized trials. (J Interven Cardiol 2004;17:65–70)

Journal

Journal of Interventional Cardiology – Wiley

Published: Apr 1, 2004

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