Factors related to a clinically silent peri-procedural drop in hemoglobin with coronary and peripheral vascular interventions

Zehra Jaffery, Christopher J. White, Tyrone J. Collins, Mark A. Grise, J. Stephen Jenkins, Paul W. McMullan, Rajan A. Patel, John P. Reilly, Stanley N. Thornton, Stephen R. Ramee

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Clinically evident and subclinical peri-procedural bleeding following interventional therapies are associated with adverse cardiovascular outcomes. The risk factors for clinically evident bleeding have been well described. Despite the well-documented association of adverse outcomes for patients with a subclinical peri-procedural hemoglobin drop, the clinical predictors have not yet been defined. We identified 1176 consecutive patients with a subclinical drop in hemoglobin (fall of ≥ 1 g/dl in patients without clinical bleeding) following percutaneous coronary interventions (PCI) and peripheral vascular interventions (PVI). Multivariate logistic regression analysis was performed. A subclinical peri-procedural hemoglobin drop ≥ 1 g/dl was identified in 41% (400/972) of PCI and in 49% (213/435) of PVI. More than one access site predicted a higher risk of a subclinical drop in hemoglobin in both groups. A body mass index ≥ 30 predicted a lower risk of a subclinical drop in hemoglobin in both groups. For PCI, creatinine clearance < 60 ml/min was associated with a higher risk of a subclinical drop in hemoglobin. In conclusion, clinically silent peri-procedural hemoglobin fall ≥ 1 g/dl is common in patients undergoing both coronary and peripheral percutaneous intervention. Predictors identified in our study will need prospective validation.

Original languageEnglish (US)
Pages (from-to)354-359
Number of pages6
JournalVascular Medicine
Volume16
Issue number5
DOIs
StatePublished - Oct 2011
Externally publishedYes

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Keywords

  • complication
  • percutaneous interventions
  • peri-procedural hemoglobin drop
  • predictors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Jaffery, Z., White, C. J., Collins, T. J., Grise, M. A., Jenkins, J. S., McMullan, P. W., Patel, R. A., Reilly, J. P., Thornton, S. N., & Ramee, S. R. (2011). Factors related to a clinically silent peri-procedural drop in hemoglobin with coronary and peripheral vascular interventions. Vascular Medicine, 16(5), 354-359. https://doi.org/10.1177/1358863X11417622