Comparison of Bleeding Complications Between Primary PCI and Rescue PCI Procedures

Background: Bleeding during or after primary percutaneous coronary intervention (PCI) is the most common noncardiac complication in patients treated for cardiac ischemic events. The present study aimed to compare bleeding complications between primary and rescue PCI procedures. Methods: In a prospective study, the recorded files of 95 consecutive patients who underwent one of the 2 procedures of primary PCI (n=90) or rescue PCI (n=5) were evaluated. The consequences of bleeding were assessed through the measurement of serum hemoglobin levels before, immediately after, and 24 hours after the procedures. Within the hospitalization period and before discharge, any occurrence of bleeding was recorded. Results: Regarding postoperative events, hematoma was revealed in 3.3% in the primary PCI group and 20% in the rescue PCI group, with no significant difference (P=0.224). Additionally, gastrointestinal bleeding was reported in 2.2% of the patients who underwent primary PCI and none of those in the other group, without any difference (P=0.999). In total, postoperative morbidity was seen in 5.6% in the primary PCI group and in 20% in the rescue PCI group, with no difference (P=0.314). The mean of the decreased level of serum hemoglobin in the primary PCI group and the rescue PCI group was 1.22±1.31 and 1.33±0.90, respectively, with no difference (P=0.849). A multivariate linear regression model, after adjustments for the baseline parameters, showed no difference between the 2 procedures regarding the decreased level of serum hemoglobin. Advanced age was the only variable able to predict higher morbidity. Conclusions: There were no significant differences in postprocedural complications regarding major bleeding between the 2 procedures of rescue PCI and primary PCI. The main predictor for bleeding after PCI was advanced age.