Advertisement

Click here for more guidelines.

 
 




CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2009; 53:2019-2027, doi:10.1016/j.jacc.2008.12.073
© 2009 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View Related Cardiosource Journal Scan
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (17)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Doyle, B. J.
Right arrow Articles by Holmes, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Doyle, B. J.
Right arrow Articles by Holmes, D. R., Jr
Related Collections
Right arrowRelated Article

STATE-OF-THE-ART PAPER

Bleeding, Blood Transfusion, and Increased Mortality After Percutaneous Coronary Intervention

Implications for Contemporary Practice

Brendan J. Doyle, MB, BCh*, Charanjit S. Rihal, MD, MBA*, Dennis A. Gastineau, MD{dagger} and David R. Holmes, Jr, MD{dagger},*

* Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
{dagger} Division of Hematology and Transfusion Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota

Manuscript received June 27, 2008; revised manuscript received December 15, 2008, accepted December 15, 2008.

* Reprint requests and corresponding: Dr. David R. Holmes, Jr., Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905 (Email: holmes.david{at}mayo.edu).

Advances in percutaneous coronary intervention (PCI) during the past decade have led to more widespread use of these procedures in older and sicker patients. Refinement of periprocedural antithrombotic therapy has played a particularly important role in reducing ischemic complications to very low levels in routine practice. Although the use of more powerful antiplatelet agents has been associated with increased risk of bleeding (especially among the elderly and patients with serious comorbidities), such complications have traditionally been viewed as benign in nature. Recent studies, however, have identified major bleeding after PCI as an important predictor of increased mortality. Whether this relationship between bleeding and risk of death is cause-and-effect, or merely an association based on shared risk factors, remains unclear. In this review, we examine the basis for a possible causal link between post-PCI bleeding and subsequent mortality. Possible mechanisms underpinning such a link are discussed, including a potential adverse role for blood transfusion in this setting. A framework for further clinical evaluation of this issue is presented.

Key Words: bleeding • blood transfusion • percutaneous coronary intervention

Abbreviations and Acronyms
  MI = myocardial infarction
  NO = nitric oxide
  PAI = plasminogen activator inhibitor
  PCI = percutaneous coronary intervention
  RBC = red blood cell(s)
  TRIM = transfusion-related immunomodulation


Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A29. [Full Text] [PDF]



This article has been cited by other articles:


Home page
Vasc MedHome page
Z. Jaffery, C. J. White, T. J. Collins, M. A. Grise, J. S. Jenkins, P. W. McMullan, R. A. Patel, J. P. Reilly, S. N. Thornton, and S. R. Ramee
Factors related to a clinically silent peri-procedural drop in hemoglobin with coronary and peripheral vascular interventions
Vascular Medicine, October 1, 2011; 16(5): 354 - 359.
[Abstract] [PDF]


Home page
Circ Cardiovasc IntervHome page
W. T. Ball, W. Sharieff, S. S. Jolly, T. Hong, M. J. B. Kutryk, J. J. Graham, N. P. Fam, R. J. Chisholm, and A. N. Cheema
Characterization of Operator Learning Curve for Transradial Coronary Interventions
Circ Cardiovasc Interv, August 1, 2011; 4(4): 336 - 341.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
R. Mehran, S. V. Rao, D. L. Bhatt, C. M. Gibson, A. Caixeta, J. Eikelboom, S. Kaul, S. D. Wiviott, V. Menon, E. Nikolsky, et al.
Standardized Bleeding Definitions for Cardiovascular Clinical Trials: A Consensus Report From the Bleeding Academic Research Consortium
Circulation, June 14, 2011; 123(23): 2736 - 2747.
[Full Text] [PDF]


Home page
J Am Coll Cardiol IntvHome page
R. Mehran, S. Pocock, E. Nikolsky, G. D. Dangas, T. Clayton, B. E. Claessen, A. Caixeta, F. Feit, S. V. Manoukian, H. White, et al.
Impact of Bleeding on Mortality After Percutaneous Coronary Intervention: Results From a Patient-Level Pooled Analysis of the REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy), and HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) Trials
J. Am. Coll. Cardiol. Intv., June 1, 2011; 4(6): 654 - 664.
[Abstract] [Full Text] [PDF]


Home page
European Journal of Cardiovascular Prevention & RehabilitationHome page
F. Bellotto, P. Palmisano, L. Compostella, N. Russo, M. Zaccaria, P. Guida, T. Setzu, A. Cati, A. Maddalozzo, S. Favale, et al.
Anemia does not preclude increments in cardiac performance during a short period of intensive, exercise-based cardiac rehabilitation
European Journal of Cardiovascular Prevention & Rehabilitation, April 1, 2011; 18(2): 150 - 157.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll Cardiol IntvHome page
F. W. A. Verheugt, S. R. Steinhubl, M. Hamon, H. Darius, P. G. Steg, M. Valgimigli, S. P. Marso, S. V. Rao, A. H. Gershlick, A. M. Lincoff, et al.
Incidence, Prognostic Impact, and Influence of Antithrombotic Therapy on Access and Nonaccess Site Bleeding in Percutaneous Coronary Intervention
J. Am. Coll. Cardiol. Intv., February 1, 2011; 4(2): 191 - 197.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
D. J. Kumbhani and D. L. Bhatt
Platelet activation: yet another strike against routine TRANSFUSION
Eur. Heart J., November 2, 2010; 31(22): 2712 - 2714.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. Sibbing, S. R. Steinhubl, S. Schulz, A. Schomig, and A. Kastrati
Platelet Aggregation and Its Association With Stent Thrombosis and Bleeding in Clopidogrel-Treated Patients: Initial Evidence of a Therapeutic Window
J. Am. Coll. Cardiol., July 20, 2010; 56(4): 317 - 318.
[Full Text] [PDF]


Home page
VASC ENDOVASCULAR SURGHome page
S. Noor, S. Meyers, and R. Curl
Successful Reduction of Surgeries Secondary to Arterial Access Site Complications: A Retrospective Review at a Single Center with an Extravascular Closure Device
Vascular and Endovascular Surgery, July 1, 2010; 44(5): 345 - 349.
[Abstract] [PDF]


Home page
Circ Cardiovasc Qual OutcomesHome page
A. P. Amin, S. P. Marso, S. V. Rao, J. Messenger, P. S. Chan, J. House, K. Kennedy, K. Robertus, D. J. Cohen, and E. M. Mahoney
Cost-Effectiveness of Targeting Patients Undergoing Percutaneous Coronary Intervention for Therapy With Bivalirudin Versus Heparin Monotherapy According to Predicted Risk of Bleeding
Circ Cardiovasc Qual Outcomes, July 1, 2010; 3(4): 358 - 365.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. Brinker
The Score Is in but Is the Decision Final?
J. Am. Coll. Cardiol., June 8, 2010; 55(23): 2567 - 2569.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. V. Rao, M. G. Cohen, D. E. Kandzari, O. F. Bertrand, and I. C. Gilchrist
The Transradial Approach to Percutaneous Coronary Intervention: Historical Perspective, Current Concepts, and Future Directions
J. Am. Coll. Cardiol., May 18, 2010; 55(20): 2187 - 2195.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
K. P. Alexander and E. D. Peterson
Minimizing the Risks of Anticoagulants and Platelet Inhibitors
Circulation, May 4, 2010; 121(17): 1960 - 1970.
[Full Text] [PDF]


Home page
Circ Cardiovasc IntervHome page
D. T. Ko, L. Yun, H. C. Wijeysundera, C. A. Jackevicius, S. V. Rao, P. C. Austin, J. F. Marquis, and J. V. Tu
Incidence, Predictors, and Prognostic Implications of Hospitalization for Late Bleeding After Percutaneous Coronary Intervention for Patients Older Than 65 Years
Circ Cardiovasc Interv, April 1, 2010; 3(2): 140 - 147.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
G. W. Stone and S. J. Pocock
Randomized Trials, Statistics, and Clinical Inference
J. Am. Coll. Cardiol., February 2, 2010; 55(5): 428 - 431.
[Abstract] [Full Text] [PDF]


Home page
Oxford Textbook of Interventional CardiologyHome page
S. Massberg, J. Mehilli, and A. Kastrati
Chapter 25 The role of bivalirudin in percutaneous coronary intervention
Oxford Textbook of Interventional Cardiology, January 1, 2010; 1(1): med-9780199569083-chapter - med-9780199569083-chapter.
[Abstract] [Full Text]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement