Hemorrhagic and vascular complications after percutaneous coronary intervention with adjunctive abciximab

Objectives: To examine the frequency and nature of hemorrhagic and peripher al vascular complications associated with use of abciximab during percutane ous coronary intervention and to characterize high-risk patients. Patients and Methods: We report the frequency and severity of bleeding and vascular complications recorded prospectively in 2559 consecutive nonselect ed patients who underwent percutaneous coronary intervention at Mayo Clinic , Rochester, Minn, between July 1, 1996, and April 30, 1998, 831 of whom re ceived abciximab and 1728 did not. Abciximab and heparin were administered according to guidelines of the Evaluation of PTCA [percutaneous translumina l coronary angioplasty] to Improve Long-Term Outcome With Abciximab GP IIb/ IIIa Blockade (EPILOG). Results: Patients who received abciximab were more likely to be men, were m ore often treated within 12 hours of an acute myocardial infarction, and we re more likely to have received heparin after the procedure (8.7% vs 4.5%, P < .001). Major bleeding occurred in 18 patients (2.4%) who received abcix imab and in 10 patients (0.6%) who did not receive abciximab (P < .001). Mi nor bleeding occurred in 108 patients (14.3%) and in 92 patients (5.9%), re spectively (P < .001). Both major bleeding and minor bleeding were more fre quent among patients within 12 hours of an acute myocardial infarction and were more frequent if abciximab had been used. Multivariate analysis reveal ed that use of abciximab was independently associated with major and minor bleeding. Conclusion: In this clinical setting, use of adjunctive abciximab during pe rcutaneous coronary intervention was associated with a significantly increa sed risk of both major and minor bleeding.