Methods
The risk of 1-year all-cause mortality was evaluated in 7718 pts who underwent PCI via femoral access. Patients with cardiogenic shock were excluded. Vascular complications were defined as: hematoma >4 cm, AV fistula, pseudoaneurysm, retroperitoneal bleeding or access site surgical repair. Patients with VCs were then stratified by the severity of hematocrit (HCT) drop following the procedure into three groups: (a) VC and severe HTC drop (upper quartile of HTC drop, ≥9.2%); (b) VC and moderate HTC drop (second quartile of HTC drop, ≥5.8% but <9.2%); (c) VC and no HTC drop (the remaining VC pts, HTC drop <5.8%).
Methods
The risk of 1-year all-cause mortality was evaluated in 7718 pts who underwent PCI via femoral access. Patients with cardiogenic shock were excluded. Vascular complications were defined as: hematoma >4 cm, AV fistula, pseudoaneurysm, retroperitoneal bleeding or access site surgical repair. Patients with VCs were then stratified by the severity of hematocrit (HCT) drop following the procedure into three groups: (a) VC and severe HTC drop (upper quartile of HTC drop, ≥9.2%); (b) VC and moderate HTC drop (second quartile of HTC drop, ≥5.8% but <9.2%); (c) VC and no HTC drop (the remaining VC pts, HTC drop <5.8%).
Results
A total of 444 (5.8%) pts had VCs. Compared with those without VCs, pts with VCs were older ( P <.01) and had more peripheral vascular disease ( P <.02) and renal failure ( P <.01). The VC pts presented more frequently as acute MI ( P <.01) and less frequently received bivalirudin or closure devices ( P <.01 for both). The mortality at 1 year was 5.4% in pts without VCs, 10.3% in the VC and no HTC drop group, 10.6% in the VC and moderate HTC drop group and 17.0% in the VC and severe HTC drop group ( P <.01). However, after adjustment, only pts with VC and severe HTC drop had an increased risk of death at 1 year ( Fig. 1 ). Age (OR 1.18, 95% CI 1.06–1.32), male gender (OR 0.40, 95% CI 0.25–0.64), intraaortic balloon pump (OR 2.31, 95% CI 1.00–5.34), bivalirudin anticoagulation (OR 0.54, 95% CI 0.32–0.94) and closure devices (OR 0.41, 95% CI 0.25–0.66) were independent predictors of the group with higher mortality.
