Exercise Caution: Meta-analysis reports significant prevalence of bleeding after PCI

The researchers suggest that interventional cardiologists should consider the effective factors in these bleeding and how to control and treat them due to the importance of this complication.

Percutaneous coronary intervention (PCI) is one of the most widely used methods for treating coronary artery disease. Previous studies have shown that complications such as hematoma, bleeding, and embolism may occur due to the trauma inflicted on the vessels during the procedure. Among these complications, the most common one of PCI is bleeding, which is tied to an increased risk of adverse events, including myocardial infarction (MI), death, and stroke, and an increased length of hospital costs and stay.

Reza Heidary Moghadam, Kermanshah University of Medical Sciences, Kermanshah, Iran, and colleagues aimed to determine the prevalence of bleeding after PCI through a systematic review and meta-analysis covering the period from 1989 to 2023.

Multiple databases were searched using validated keywords. The I2 index was used to check for heterogeneity among studies. The meta-analysis included observational studies (case-control studies, cohort studies, cross-sectional studies), access to the full text of the article, randomized clinical trials, and studies that reported the frequency or percentage of bleeding after PCI.

Based on the analysis, the researchers reported the following findings:

• The review of 8 studies, with a sample size of 397,298 participants, showed high heterogeneity (I2: 97.8 %). Therefore, the random effects method was used to analyze the results.
• The prevalence of bleeding after intervention in percutaneous coronary arteries was reported to be 4.4 %.

In conclusion, the incidence of bleeding after PCI was reported to be 4.4 %, which is a significant result. Therefore, the results can serve as an important criterion for developing suitable treatment and prevention strategies.

"Health policymakers can also utilize the findings of the meta-analysis to prioritize research on the complication of bleeding after PCI and its outcomes and implement effective measures to prevent and manage this complication.," the researchers wrote.

One limitation of the meta-analysis is that it only included studies published in English, potentially excluding relevant studies published in other languages. Furthermore, various studies were excluded due to inadequate quality, such as those that did not report prevalence and those with small sample sizes.

Reference:

Heidary Moghadam R, Mohammadi A, Salari N, Ahmed A, Shohaimi S, Mohammadi M. The prevalence of bleeding after percutaneous coronary interventions: A systematic review and meta-analysis. Indian Heart J. 2024 Jan-Feb;76(1):16-21. doi: 10.1016/j.ihj.2024.01.009. Epub 2024 Jan 10. PMID: 38216122.