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

Golnaz Sadjadieh, Thomas Engstrøm, Steffen Helqvist, Dan Eik Høfsten, Lars Køber, Frants Pedersen, Peter Clemmensen, Erik Jørgensen, Kari Saunamäki, Hans-Henrik Tilsted, Henning Kelbæk, Lene Holmvang

    5 Citationer (Scopus)

    Abstract

    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.

    OriginalsprogEngelsk
    TidsskriftEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
    Vol/bind12
    Udgave nummer10
    Sider (fra-til)1231-1238
    Antal sider8
    ISSN1774-024X
    DOI
    StatusUdgivet - 20 nov. 2016

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