Bleeding episodes in "complete, staged" versus "culprit only" revascularisation in patients with multivessel disease and ST-segment elevation myocardial infarction: a DANAMI-3-PRIMULTI substudy
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Bleeding episodes in "complete, staged" versus "culprit only" revascularisation in patients with multivessel disease and ST-segment elevation myocardial infarction: a DANAMI-3-PRIMULTI substudy. / Sadjadieh, Golnaz; Engstrøm, Thomas; Helqvist, Steffen; Høfsten, Dan Eik; Køber, Lars; Pedersen, Frants; Clemmensen, Peter; Jørgensen, Erik; Saunamäki, Kari; Tilsted, Hans-Henrik; Kelbæk, Henning; Holmvang, Lene.
in: EUROINTERVENTION, Jahrgang 12, Nr. 10, 20.11.2016, S. 1231-1238.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Bleeding episodes in "complete, staged" versus "culprit only" revascularisation in patients with multivessel disease and ST-segment elevation myocardial infarction: a DANAMI-3-PRIMULTI substudy
AU - Sadjadieh, Golnaz
AU - Engstrøm, Thomas
AU - Helqvist, Steffen
AU - Høfsten, Dan Eik
AU - Køber, Lars
AU - Pedersen, Frants
AU - Clemmensen, Peter
AU - Jørgensen, Erik
AU - Saunamäki, Kari
AU - Tilsted, Hans-Henrik
AU - Kelbæk, Henning
AU - Holmvang, Lene
PY - 2016/11/20
Y1 - 2016/11/20
N2 - AIMS: The aim of this study was to evaluate whether a staged in-hospital complete revascularisation strategy increases the risk of serious bleeding events in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease.METHODS AND RESULTS: The DANAMI-3-PRIMULTI trial investigated whether a staged in-hospital complete revascularisation strategy improved outcome in patients with STEMI and multivessel disease. In this substudy, we investigated potential bleeding complications related to a second in-hospital procedure. Bleedings were assessed using BARC and TIMI criteria. Six hundred and twenty-seven (627) patients were randomised 1:1 to either PCI of the infarct-related artery (IRA) only (n=313) or complete revascularisation during a staged procedure before discharge (n=314). We found no significant difference in TIMI major+minor bleedings related to the primary PCI. There were neither major nor minor bleedings in relation to the second procedure in the complete revascularisation arm. There were significantly more in-hospital minimal+medical attention bleedings in the group randomised to complete revascularisation (61.5% vs. 49.5% in the IRA-PCI only group, p=0.003), but no difference in admission time or one-year mortality (2.2% complete revascularisation-group vs. 2.6% IRA-PCI only group, p=0.8).CONCLUSIONS: In multivessel diseased STEMI patients, a staged complete in-hospital revascularisation strategy or any second in-hospital procedure did not result in an increase in serious bleeding events.
AB - AIMS: The aim of this study was to evaluate whether a staged in-hospital complete revascularisation strategy increases the risk of serious bleeding events in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease.METHODS AND RESULTS: The DANAMI-3-PRIMULTI trial investigated whether a staged in-hospital complete revascularisation strategy improved outcome in patients with STEMI and multivessel disease. In this substudy, we investigated potential bleeding complications related to a second in-hospital procedure. Bleedings were assessed using BARC and TIMI criteria. Six hundred and twenty-seven (627) patients were randomised 1:1 to either PCI of the infarct-related artery (IRA) only (n=313) or complete revascularisation during a staged procedure before discharge (n=314). We found no significant difference in TIMI major+minor bleedings related to the primary PCI. There were neither major nor minor bleedings in relation to the second procedure in the complete revascularisation arm. There were significantly more in-hospital minimal+medical attention bleedings in the group randomised to complete revascularisation (61.5% vs. 49.5% in the IRA-PCI only group, p=0.003), but no difference in admission time or one-year mortality (2.2% complete revascularisation-group vs. 2.6% IRA-PCI only group, p=0.8).CONCLUSIONS: In multivessel diseased STEMI patients, a staged complete in-hospital revascularisation strategy or any second in-hospital procedure did not result in an increase in serious bleeding events.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Coronary Artery Disease/therapy
KW - Electrocardiography/methods
KW - Female
KW - Hemorrhage/complications
KW - Hospitals/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Revascularization/methods
KW - Percutaneous Coronary Intervention/methods
KW - ST Elevation Myocardial Infarction/therapy
KW - Treatment Outcome
U2 - 10.4244/EIJV12I10A203
DO - 10.4244/EIJV12I10A203
M3 - SCORING: Journal article
C2 - 27866133
VL - 12
SP - 1231
EP - 1238
JO - EUROINTERVENTION
JF - EUROINTERVENTION
SN - 1774-024X
IS - 10
ER -