Skip to main content

Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial.

Publication ,  Journal Article
Kansal, A; Huang, Z; Rockhold, FW; Baumgartner, I; Berger, JS; Blomster, JI; Fowkes, FG; Katona, B; Mahaffey, KW; Norgren, L; Hiatt, WR ...
Published in: Circ Cardiovasc Interv
October 2019

BACKGROUND: The relationship between invasive vascular procedures and bleeding in patients with peripheral artery disease has not been well described in the literature. This post hoc analysis from the EUCLID trial (Examining Use of Ticagrelor in Peripheral Artery Disease) aimed to describe the incidence of major and minor postprocedural bleeding and characterize the timing and severity of bleeding events relative to the procedure. METHODS: EUCLID was a multicenter, randomized controlled trial of 13 885 patients with symptomatic peripheral artery disease that tested the efficacy and safety of ticagrelor compared with clopidogrel for the prevention of major adverse cardiovascular events. A total of 2661 patients underwent 3062 coronary revascularization, peripheral revascularization, and amputation during the study. The primary safety end point was Thrombolysis in Myocardial Infarction major or minor bleeding. All bleeding events were formally adjudicated by a clinical end point classification group. RESULTS: Major bleeding events most often occurred ≤7 days following the procedure. The incidence of Thrombolysis in Myocardial Infarction major or minor bleeding ≤7 days following peripheral revascularization (3.3%; 95% CI, 2.5%-4.1%) was similar to rates after coronary revascularization (4.0%; 95% CI, 2.6%-5.4%) and lower extremity amputation (2.3%; 95% CI, 0.8%-3.8%). The severity of bleeding events (as graded by drop in hemoglobin, need for transfusion, bleeding in a critical location, and fatal bleeding) was also similar following peripheral, coronary revascularization, and lower extremity amputation. CONCLUSIONS: The incidence of Thrombolysis in Myocardial Infarction major/minor bleeding following peripheral revascularization is comparable to rates after coronary revascularization and lower extremity amputation, and the majority of bleeding events occur within 7 days following the procedure. The severity of periprocedural bleeding is also similar after procedures, with the most frequently adjudicated reason being a drop in hemoglobin ≥2 g/dL. Future studies should be performed to enhance our understanding of bleeding risk related to revascularization and amputation procedures in peripheral artery disease patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

October 2019

Volume

12

Issue

10

Start / End Page

e008069

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Ticagrelor
  • Risk Factors
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kansal, A., Huang, Z., Rockhold, F. W., Baumgartner, I., Berger, J. S., Blomster, J. I., … Jones, W. S. (2019). Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial. Circ Cardiovasc Interv, 12(10), e008069. https://doi.org/10.1161/CIRCINTERVENTIONS.119.008069
Kansal, Aman, Zhen Huang, Frank W. Rockhold, Iris Baumgartner, Jeffrey S. Berger, Juuso I. Blomster, F Gerry Fowkes, et al. “Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial.Circ Cardiovasc Interv 12, no. 10 (October 2019): e008069. https://doi.org/10.1161/CIRCINTERVENTIONS.119.008069.
Kansal A, Huang Z, Rockhold FW, Baumgartner I, Berger JS, Blomster JI, et al. Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial. Circ Cardiovasc Interv. 2019 Oct;12(10):e008069.
Kansal, Aman, et al. “Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial.Circ Cardiovasc Interv, vol. 12, no. 10, Oct. 2019, p. e008069. Pubmed, doi:10.1161/CIRCINTERVENTIONS.119.008069.
Kansal A, Huang Z, Rockhold FW, Baumgartner I, Berger JS, Blomster JI, Fowkes FG, Katona B, Mahaffey KW, Norgren L, Hiatt WR, Patel MR, Jones WS. Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial. Circ Cardiovasc Interv. 2019 Oct;12(10):e008069.

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

October 2019

Volume

12

Issue

10

Start / End Page

e008069

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Ticagrelor
  • Risk Factors
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Humans