Comparison of Bleeding Complications Between Primary PCI and Rescue PCI Procedures

Authors

1 Department of Cardiology, Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran

2 Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

3 Department of Vascular Surgery, Zahra Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran

4 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

Abstract

Background: Bleeding during or after primary percutaneous coronary intervention (PCI) is the most
common noncardiac complication in patients treated for cardiac ischemic events. The present
study aimed to compare bleeding complications between primary and rescue PCI procedures.
Methods: In a prospective study, the recorded files of 95 consecutive patients who underwent one of
the 2 procedures of primary PCI (n=90) or rescue PCI (n=5) were evaluated. The consequences
of bleeding were assessed through the measurement of serum hemoglobin levels before,
immediately after, and 24 hours after the procedures. Within the hospitalization period and
before discharge, any occurrence of bleeding was recorded.
Results: Regarding postoperative events, hematoma was revealed in 3.3% in the primary PCI group
and 20% in the rescue PCI group, with no significant difference (P=0.224). Additionally,
gastrointestinal bleeding was reported in 2.2% of the patients who underwent primary PCI and
none of those in the other group, without any difference (P=0.999). In total, postoperative
morbidity was seen in 5.6% in the primary PCI group and in 20% in the rescue PCI group, with
no difference (P=0.314). The mean of the decreased level of serum hemoglobin in the primary
PCI group and the rescue PCI group was 1.22±1.31 and 1.33±0.90, respectively, with no
difference (P=0.849). A multivariate linear regression model, after adjustments for the baseline
parameters, showed no difference between the 2 procedures regarding the decreased level of
serum hemoglobin. Advanced age was the only variable able to predict higher morbidity.
Conclusions: There were no significant differences in postprocedural complications regarding major
bleeding between the 2 procedures of rescue PCI and primary PCI. The main predictor for
bleeding after PCI was advanced age.

Keywords