PSU44 MANAGEMENT OF PERIPROCEDURAL THROMBOTIC AND BLEEDING EVENTS IN PERCUTANEOUS CORONARY INTERVENTIONS IN EUROPE: PILOT SURVEY OF TREATMENT STRATEGIES AND HOSPITAL RESOURCES USE

Abstract

Evidence generation about real world medical practice in Europe regarding percutaneous coronary intervention (PCI) and periprocedural platelet aggregation inhibition management, as well as identification of current medical needs in this field. A survey focusing on periprocedural PCI management was distributed to interventional cardiologists in Europe. All answers and the responders’ personal information were coded and anonymized. The template consisted of 32 questions and 77 variables. Questions included information about epidemiological data on PCI procedures, current management of periprocedural thrombotic and bleeding events potentially associated with oral P2Y12 inhibitors (pre-loading) and glycoprotein IIb/IIIa inhibitors (bailout) respectively, as well as use of healthcare resources. 14 questionnaires were completed (Belgium (n=1), Germany (n=1), France (n=6), Portugal (n=3) and Spain (n=3)). Adherence to Guidelines in PCI management was high in all countries. Large variability was observed regarding the percentage of complex PCI performed per year, from 10% (Belgium) to 60% (Spain). The reported proportion of thrombotic and bleeding events in the first 48 h was 1%-50% and 2%-44% respectively. The average length of hospital stay in case of periprocedural events varied from 2 to up to 11 days. In general, average use of glycoprotein IIb/IIIa inhibitors for bailout was low (<6%) except in Spain (15%). High risk PCI were mostly identified in case of cardiogenic shock or active vomit, STEMI patients and elderly. The average percentage of patients where preloading with oral P2Y12 inhibitors was not feasible or desirable was 7.4% (1%-25%). The most valued characteristics of pharmacological innovations in this field would be definitely related to fast onset of action as well as short duration of effect. An expert consensus panel on PCI management would be advisable in order to validate all results across countries and cover potential dilemmas that may arise in clinical practice as preloading and bailout.