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Predictors of Major Vascular Access Site Complications in Patients with Acute Coronary Syndromes Undergoing Percutaneous

Disclosures. Consultant: BMS, Guerbet, Sanofi-Aventis, Schering-Plough, The Medicines Co.Grant Support: Guerbet, The Medicines Co.Lecture honoraria: Guerbet, The Medicines Co.. Manoukian SV et al. TCT 2007.. Background and Methods: Study Design and Definitions. The ACUITY Trial randomized 13,819

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Predictors of Major Vascular Access Site Complications in Patients with Acute Coronary Syndromes Undergoing Percutaneous

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    1. Predictors of Major Vascular Access Site Complications in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: Insights from the ACUITY Trial Steven V Manoukian, Reza Fazel, Timothy A. Sanborn, Ramin Ebrahimi, Frederick Feit, Martial Hamon, Michele D. Voeltz, George D. Dangas, Jeffrey W. Moses, Spencer B. King III, Harvey D. White, E. Magnus Ohman, Roxana Mehran, Gregg W. Stone, on behalf of the ACUITY Investigators

    2. Disclosures Consultant: BMS, Guerbet, Sanofi-Aventis, Schering-Plough, The Medicines Co. Grant Support: Guerbet, The Medicines Co. Lecture honoraria: Guerbet, The Medicines Co.

    3. Background and Methods: Study Design and Definitions The ACUITY Trial randomized 13,819 patients with moderate and high-risk NSTE-ACS to: heparin/enoxaparin + GPIIb/IIIa inhibitor, bivalirudin + GPIIb/IIIa inhibitor, or bivalirudin alone. Major vascular access site complications were defined as: access site bleeding requiring invasive intervention, or hematoma >5cm. Major bleeding (non-CABG-related) was defined as: intracranial, intraocular, or retroperitoneal, access site with intervention, hematoma >5cm, hgb drop >3g/dL with source or >4g/dL without source, reoperation, transfusion.

    4. Background and Methods: ACUITY: Study Design

    5. Background: ACUITY PCI: Major Bleeding by Treatment Strategy

    6. Background: REPLACE-2: Predictors of Major Vascular Complications in PCI

    7. Background and Methods: Vascular Complications in PCI Major vascular assess site complications are associated with significant morbidity in ACS and PCI. We determined the baseline and procedural predictors of major vascular complications in patients with ACS undergoing PCI via the femoral approach.

    8. Results: ACUITY PCI: Management Strategy

    9. Results: ACUITY PCI: Major Vascular Complications by Treatment Strategy Do not have dataDo not have data

    10. Results: ACUITY PCI: Predictors of Major Vascular Complications

    11. Results: The ACUITY Trial PCI Population (n=7789) Vascular Complications in PCI In patients with ACS undergoing PCI via the femoral approach, independent predictors of MVC include: age =75 years, creatinine clearance <60 mL/min, female sex, prior PCI, prior CABG, and use of H+GPI (vs. BIV). Altering treatment strategy with regard to the modifiable factor (use of H+GPI) may reduce the risk of MVC.

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