PMID- 36340491
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221108
IS  - 2666-5018 (Electronic)
IS  - 2666-5018 (Linking)
VI  - 3
IP  - 5
DP  - 2022 Oct
TI  - Risk factors for hematoma in patients undergoing cardiac device procedures: A 
      WRAP-IT trial analysis.
PG  - 466-473
LID - 10.1016/j.hroo.2022.05.012 [doi]
AB  - BACKGROUND: Implant site hematoma is a known complication of cardiac device 
      procedures and can lead to major consequences. OBJECTIVES: To evaluate risk 
      factors for hematoma and further understand the relationship between 
      anticoagulant (AC), antiplatelet (AP) use, and hematoma development. METHODS: We 
      included 6800 patients from the WRAP-IT trial. To assess baseline and procedural 
      characteristics associated with hematoma within the first 30 days postprocedure, 
      a stepwise Cox regression model was implemented with minimal Akaike information 
      criterion. Cox regressions were also used to evaluate AC/AP use and hematoma 
      risk. RESULTS: The overall rate of hematoma was 2.2%. The model identified 11 
      baseline and procedural characteristics associated with hematoma risk. AC use 
      (hazard ratio [HR]: 2.44, P < .001), lower body mass index (HR: 1.06, P < .001), 
      and history of valve surgery (HR: 2.11, P < .001) were associated with the 
      highest risk. AP use, male sex, history of coronary artery disease, existing 
      pocket, history of nonischemic cardiomyopathy, number of previous cardiac 
      implantable electronic device (CIED) procedures, procedure time, and lead 
      revision were associated with moderate risk. Antithrombotic use was high overall 
      (86%) and AC+AP use was highly predictive of hematoma risk. Regardless of AC 
      status, AP use was associated with an almost doubling of risk vs no AP (HR = 
      1.85, P = .0006) in the general cohort. Interruption of AC was associated with 
      the lowest hematoma risk (HR = 2.35) while heparin bridging (HR = 4.98) and AP 
      use vs no AP use (HR = 1.85) was associated with the highest hematoma risk. 
      CONCLUSION: The results of this analysis highlight risk factors associated with 
      the development of hematoma in patients undergoing CIED procedures and can inform 
      antithrombotic management.
CI  - (c) 2022 Heart Rhythm Society. Published by Elsevier Inc.
FAU - Tarakji, Khaldoun G
AU  - Tarakji KG
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Korantzopoulos, Panagiotis
AU  - Korantzopoulos P
AD  - First Department of Cardiology, University Hospital of Ioannina, Ioannina, 
      Greece.
FAU - Philippon, Francois
AU  - Philippon F
AD  - Cardiology Department, Institut Universitaire de Cardiologie et de Pneumologie de 
      Quebec (IUCPQ), Quebec, Canada.
FAU - Biffi, Mauro
AU  - Biffi M
AD  - Cardiology, Policlinico Sant' Orsola, Malpighi, Italy.
FAU - Mittal, Suneet
AU  - Mittal S
AD  - Electrophysiology, Valley Health System, Ridgewood, New Jersey.
FAU - Poole, Jeanne E
AU  - Poole JE
AD  - Division of Cardiology, University of Washington School of Medicine, Seattle, 
      Washington.
FAU - Kennergren, Charles
AU  - Kennergren C
AD  - Cardiothoracic Surgery, Sahlgrenska University Hospital, Goteborg, Sweden.
FAU - Lexcen, Daniel R
AU  - Lexcen DR
AD  - Cardiac Rhythm Management, Medtronic, Inc, Mounds View, Minnesota.
FAU - Lande, Jeff D
AU  - Lande JD
AD  - Cardiac Rhythm Management, Medtronic, Inc, Mounds View, Minnesota.
FAU - Hilleren, Gregory
AU  - Hilleren G
AD  - Cardiac Rhythm Management, Medtronic, Inc, Mounds View, Minnesota.
FAU - Seshadri, Swathi
AU  - Seshadri S
AD  - Cardiac Rhythm Management, Medtronic, Inc, Mounds View, Minnesota.
FAU - Wilkoff, Bruce L
AU  - Wilkoff BL
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20220616
PL  - United States
TA  - Heart Rhythm O2
JT  - Heart rhythm O2
JID - 101768511
PMC - PMC9626743
OTO - NOTNLM
OT  - Anticoagulation
OT  - Antiplatelet
OT  - Antithrombotic management
OT  - CIED
OT  - Complication
OT  - Hematoma
OT  - Risk factor
EDAT- 2022/11/08 06:00
MHDA- 2022/11/08 06:01
PMCR- 2022/06/16
CRDT- 2022/11/07 05:01
PHST- 2022/05/20 00:00 [received]
PHST- 2022/05/30 00:00 [accepted]
PHST- 2022/11/07 05:01 [entrez]
PHST- 2022/11/08 06:00 [pubmed]
PHST- 2022/11/08 06:01 [medline]
PHST- 2022/06/16 00:00 [pmc-release]
AID - S2666-5018(22)00142-8 [pii]
AID - 10.1016/j.hroo.2022.05.012 [doi]
PST - epublish
SO  - Heart Rhythm O2. 2022 Jun 16;3(5):466-473. doi: 10.1016/j.hroo.2022.05.012. 
      eCollection 2022 Oct.