Who is most likely to have bleeding problems after percutaneous coronary intervention (PCI)?

This study looked at the risk of bleeding after percutaneous coronary intervention (PCI). It found patients who had chronic kidney disease, low body weight, diabetes, or who were aged over 80 were most likely to have bleeding problems.

Percutaneous coronary intervention (PCI) is a procedure commonly used to treat blocked blood vessels in the heart. It involves inserting a stent into the artery in order to keep the artery open. After PCI there is a risk that the artery will become blocked again due to a blood clot. Patients, therefore, have to take medications to stop the blood from clotting. These medications are called antiplatelet medications. These medications and the PCI procedure can increase the risk of bleeding. It is not clear how many people suffer from major bleeding after PCI or what factors increase the risk of bleeding.

9,013 patients were involved in this study. All patients had a PCI and received 2 antiplatelet medications afterward. Patients were followed up for an average of 5 years.

The risk of major bleeding over 12 months was 2.3%. This risk was 5.4% after 6 years. 60% of cases of major bleeding happened in the first month after PCI.

Patients who had chronic kidney disease, diabetes, low body weight, or age over 80 were more likely to suffer a major bleed. Patients who had a heart attack or another PCI were 67% more likely to have a major bleed.

This study showed that the risk of major bleeding is higher in the first month after PCI and in older patients and those with chronic kidney disease, diabetes or low bodyweight.

Patients with major bleeding risk factors were not included in this study. Therefore the overall risk of bleeding may be higher in the general population. More studies are needed to assess this.