The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk

Keun Ho Park, Myung Ho Jeong, Youngkeun Ahn, Sang Sik Jung, Moo Hyun Kim, Hyoung Mo Yang, Junghan Yoon, Seung Woon Rha, Keum Soo Park, Kyoo Rok Han, Byung Ryul Cho, Kwang Soo Cha, Byung Ok Kim, Min Soo Hyon, Won Yong Shin, Hyunmin Choe, Jang Whan Bae, Hee Yeol Kim

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Abstract

The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.

Original languageEnglish
Pages (from-to)1307-1315
Number of pages9
JournalJournal of Korean medical science
Volume28
Issue number9
DOIs
Publication statusPublished - 2013 Sep 25

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Acute Coronary Syndrome
Blood Vessels
Hemorrhage
Thigh
Unstable Angina
Mortality
Incidence
Korea
Blood Transfusion
Registries
Odds Ratio
Guidelines
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Park, Keun Ho ; Jeong, Myung Ho ; Ahn, Youngkeun ; Jung, Sang Sik ; Kim, Moo Hyun ; Yang, Hyoung Mo ; Yoon, Junghan ; Rha, Seung Woon ; Park, Keum Soo ; Han, Kyoo Rok ; Cho, Byung Ryul ; Cha, Kwang Soo ; Kim, Byung Ok ; Hyon, Min Soo ; Shin, Won Yong ; Choe, Hyunmin ; Bae, Jang Whan ; Kim, Hee Yeol. / The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk. In: Journal of Korean medical science. 2013 ; Vol. 28, No. 9. pp. 1307-1315.
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abstract = "The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0{\%} vs 9.4{\%}, P = 0.048; 4.5{\%} vs 9.4{\%}, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1{\%} vs 15.0{\%}, P < 0.001; 7.2{\%} vs 30.0{\%}, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95{\%} confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.",
author = "Park, {Keun Ho} and Jeong, {Myung Ho} and Youngkeun Ahn and Jung, {Sang Sik} and Kim, {Moo Hyun} and Yang, {Hyoung Mo} and Junghan Yoon and Rha, {Seung Woon} and Park, {Keum Soo} and Han, {Kyoo Rok} and Cho, {Byung Ryul} and Cha, {Kwang Soo} and Kim, {Byung Ok} and Hyon, {Min Soo} and Shin, {Won Yong} and Hyunmin Choe and Bae, {Jang Whan} and Kim, {Hee Yeol}",
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Park, KH, Jeong, MH, Ahn, Y, Jung, SS, Kim, MH, Yang, HM, Yoon, J, Rha, SW, Park, KS, Han, KR, Cho, BR, Cha, KS, Kim, BO, Hyon, MS, Shin, WY, Choe, H, Bae, JW & Kim, HY 2013, 'The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk', Journal of Korean medical science, vol. 28, no. 9, pp. 1307-1315. https://doi.org/10.3346/jkms.2013.28.9.1307

The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk. / Park, Keun Ho; Jeong, Myung Ho; Ahn, Youngkeun; Jung, Sang Sik; Kim, Moo Hyun; Yang, Hyoung Mo; Yoon, Junghan; Rha, Seung Woon; Park, Keum Soo; Han, Kyoo Rok; Cho, Byung Ryul; Cha, Kwang Soo; Kim, Byung Ok; Hyon, Min Soo; Shin, Won Yong; Choe, Hyunmin; Bae, Jang Whan; Kim, Hee Yeol.

In: Journal of Korean medical science, Vol. 28, No. 9, 25.09.2013, p. 1307-1315.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk

AU - Park, Keun Ho

AU - Jeong, Myung Ho

AU - Ahn, Youngkeun

AU - Jung, Sang Sik

AU - Kim, Moo Hyun

AU - Yang, Hyoung Mo

AU - Yoon, Junghan

AU - Rha, Seung Woon

AU - Park, Keum Soo

AU - Han, Kyoo Rok

AU - Cho, Byung Ryul

AU - Cha, Kwang Soo

AU - Kim, Byung Ok

AU - Hyon, Min Soo

AU - Shin, Won Yong

AU - Choe, Hyunmin

AU - Bae, Jang Whan

AU - Kim, Hee Yeol

PY - 2013/9/25

Y1 - 2013/9/25

N2 - The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.

AB - The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.

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JF - Journal of Korean Medical Science

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