P5124Impact of admission hyperglycemia on 3-year mortality in diabetic versus non-diabetic patients undergoing primary PCI for STEMI

Abstract

compared to CRUSADE (AUC 0.76), that is mantained when we compared the risk status of the two scores (AUC 0.78 vs. 0.72). For an ATRIA>2.5pts we have a sensitivity (S) of 74% and specificity (E) of 75% for HE vs. S of 71% and E of 68.8% with CRUSADE>28.5pts. Conclusion:The ATRIA bleeding score proved to be useful for stratifying the risk of HE in P undergoing PCI. The comparison with the CRUSADE score, currently validated for this type of population, allowed us to verify that the ATRIA bleeding is superior in its performance. Its use in clinical practice may allow a better stratification and a more individualized approach to hemorrhagic risk. Having a pre-procedure Hgb of less than 11 g/L had the major impact on choice of stent used during PCI (OR: 0.51; 95% CI: 0.45 to 0.57; p<0.001). Within the HBR patient, having 3 or more HBR criteria was associated with less likelihood to receive DES than patients with one or two risk factors (OR: 0.50; 95% CI: 0.44 to 0.57; p<0.001). When we looked into the trends of DES use on HBR population, there was slow increase then slowed down around 2006 when FDA has released stent thrombosis alert. With the development of second generation DES, there was increase again of DES in HBR population. P5122 | BEDSIDE Conclusions:Presence of HBR has a significant impact upon the decision to use DES. The optimal treatment of patients with at least one HBR risk factor needs to be further explored. Background: Bleeding events in relation to primary percutaneous coronary intervention (pPCI) in ST-segment elevation Myocardial Infarction (STEMI) has been shown to have a strong association to short-and long-term mortality. However, arterial access, anticoagulation and antiplatelet strategies vary between studies and new regimens have evolved. Purpose: To investigate incidences and predictors of serious in hospital bleeding events in a contemporary STEMI population consisting of the DANAMI-3 patient population. P5123 | BEDSIDE Incidences and predictors of serious bleeding events in a contemporary STEMI population. A DANAMI-3 substudy Methods:The Third DANish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction (DANAMI-3) aimed to improve outcome in STEMI patients by different revascularization strategies. This nationwide all-comer study included 2217 STEMI patients with symptom duration under 12 hours. In this substudy, hospital charts from admission and until discharge, were read in order to detect in hospital bleeding episodes. Bleeding events were assessed using TIMI criteria. Results: Pre-hospital antithrombotic medication consisted of 10.000 units unfractionated heparin in 96% of patients, and a similar proportion received 300 mg aspirin in combination with loading of either Clopidogrel, Ticagrelor or Prasugrel before arrival in the cath.lab. A total of 76% received additional bivalirudin and/or glycoprotein inhibitor (GPI) (19%) during and after pPCI. Access site was femoral in 94%. In hospital non-CABG related TIMI major bleeding occurred in 16 (0.7%...