Minimizing Adverse Reactions by Stopping the Bleeding

Patients with acute coronary syndromes often must resort to stents or balloon angioplasty to relieve artery constriction. Now the European Society of Cardiology is suggesting new strategies to minimize bleeding during such procedures.

The European Society of Cardiology Working Group on Thrombosis is calling for greater attention by medical staff to reducing bleeding in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary interventions (PCI), such as stents and balloon angioplasty. They also are calling for increased research in the field of venous thrombosis, the formation of a blood clot in a vein.

Talk to your doctor if you have suffer from acute coronary syndrome.

The position paper was recently published in The European Heart Journal. It summarizes current knowledge regarding bleeding in ACS and PCI, and provides perspective on management strategies to minimize the extent of bleeding and subsequent adverse consequences.

Kurt Huber, a former chairman of the Working Group, from Wilhelminenspital Hospital in Vienna, Austria, said bleeding associated with PCI could be caused by many factors such as gastric ulcers or renal dysfunction.

New evidence suggests a strong and potentially modifiable link between bleeding and adverse outcomes. A 2006 study by John Eikelboom, which looked at the association between bleeding and death or ischemic events in almost 35,000 patients with ACS, found that those who experienced major bleeds had a fivefold higher incidence of death during the first 30 days, and a 1.5 fold higher incidence of death between 30 days and 6 months.

The position paper suggests strategies such as using radial instead of femoral access for angiography and PCI, and adjusting the dose of anticoagulant agents to body weight, age and renal function.

The Working Group on Thrombosis also praised recent efforts of the Bleeding Academic Research Consortium to produce a consensus definition of bleeding for cardiovascular clinical trials.