Skip to main content

Main menu

  • About Us
    • Leadership
    • Our Team
    • Vision, Mission and Values
    • Health and Economic Impact
    • Strategic Plan
  • Our Research
    • Research Focus
      • Brain Health
      • Cancer
      • Cardiovascular Conditions and Diseases
      • Digital Health
      • Health Policy
      • Immunity and Infectious Diseases
      • Joint Health and Mobility
      • Respiratory and Lung Health
      • Spinal Cord Injury and Rehabilitation
    • Research Centres and Programs
      • BC Centre on Substance Use
      • Centre for Cardiovascular Innovation
      • Centre for Clinical Epidemiology and Evaluation
      • Centre for Hip Health and Mobility
      • Centre for Lung Health
      • Djavad Mowafaghian Centre for Brain Health
      • Immunity and Infection Research Centre
      • International Collaboration On Repair Discoveries
      • Ovarian Cancer Research Centre
      • Vancouver Prostate Centre
      • Community Research Program
      • Emergency Medicine Research Program
      • Hematology Research Program
      • Rehabilitation Research Program
      • Skin Research Program
      • Other Research Focus Areas
    • News and Stories
    • Researcher Directory
    • Events and Workshops
  • Research Services
    • New to VCHRI
      • Working at VCHRI
      • Regulations and Training
      • Membership with VCHRI
    • Starting Your Project
      • Research Facilitation
      • Awards and Funding
      • Grant Management
      • Operational Approval
    • Developing Your Project
      • Clinical Trials Administration
      • Clinical Research Unit
      • CST Cerner at VCH
      • Research Privacy
      • Financial Policies and Procedures
    • Additional Support
      • Education and Training
      • Communications and Branding
      • Media Relations
      • Study Recruitment Support
      • Innovation and Industry Partnership
    • Internal Awards
    • Clinical Research
    • Innovation and Partnership
  • Participate in Research
    • Reasons to Participate
    • Participant Stories
    • Find a Study
    • Recruitment Support

User menu

  • Log in

Breadcrumb

  1. Home
  2. Our Research
  3. News and Stories
  4. Zeroing in on the causes of major bleeds among heart attack patients

Zeroing in on the causes of major bleeds among heart attack patients

Stories Feb 18, 2022 3 minutes

Research findings suggest that unseen sources of significant blood loss may pose the greatest risk.

Time is of the essence to administer the best possible treatment when a patient enters the hospital with a heart attack. In the case of patients with ST-elevation myocardial infarction (STEMI) — one of the most dangerous and potentially deadly forms of heart attack — the coronary artery is completely blocked, restricting life-giving blood from flowing through the arteries to the heart muscle.

“When a patient arrives at the emergency department with STEMI, it is a race against time to open up the artery and get blood flowing again,” explains cardiologist and Vancouver Coastal Health Research Institute researcher Dr. Graham Wong.

Dr. Graham Wong is a clinical professor in the Department of Medicine at the University of British Columbia and a member of the Centre for Cardiovascular Innovation. He is the associate director of the Coronary Care Unit at Vancouver General Hospital, the program director for the UBC Adult Cardiology Training Program and the medical director for the Vancouver Coastal Health Authority/Providence Health Care STEMI Program.

Patients with STEMI are often treated with an emergency procedure called primary percutaneous coronary intervention (pPCI) to open up the blockage. This is a non-surgical approach in which clinicians thread a flexible, long and hollow tube through an artery in the patient’s groin or arm. The tube is mounted with a small balloon that is inflated in the blockage to expand the artery and restore blood flow. A small metal stent is then usually inserted to ‘scaffold’ the artery open.

A leading potential negative consequence of pPCI is major bleeding: when patients may require blood transfusions and/or another urgent procedure to stop blood loss and replenish depleted blood stores.

Wong’s research is the first of its kind to compare access-site and non-access-site major bleeding among in-hospital, adult STEMI patients who have received pPCI.

Access-site major bleeding can occur at the incision point for the balloon-mounted tube. Non-access-site major bleeding can be located anywhere else in a patient’s body. This is largely due to either medications used during treatment or other factors, such as comorbidities, a patients’ age and a drop in hemoglobin — a protein found in red blood cells — that can starve the organs of oxygenated blood.

“With any intervention that is used to treat a blocked artery that caused a heart attack, you need to use powerful blood thinners, which can also lead to problems such as major bleeding,” adds Wong.

Non-access-site major bleeding shown to be the greater risk factor

Among STEMI patients, major bleeding prevention is not only important for stopping excess blood loss, it can also decrease the risk of short- and long-term consequences such as heart attack, stroke or even death.

“Any major bleeding experienced by heart attack patients has the potential to lead to poorer outcomes.”

Wong’s research study, published in CJC Open, the journal of the Canadian Cardiovascular Society, examined in-hospital access-site and non-access-site major bleeding among 1,494 STEMI patients who received pPCI between 2012 and 2018.

He found that 121 patients (8.1 per cent) experienced major bleeding. Among these, 87 had major bleeding away from the incision site and 34 experienced it where the stent tube was inserted. While 23 patients passed away as a result of non-access-site major bleeding, only two passed away from access-site major bleeding. 

“Previously, a lot of attention has been paid to access-site major bleeding, and I think our research has shown that non-access-site major bleeding is just as important, and may even be more important with respect to outcomes.”

Similarly, cardiac arrest — when the heart stops beating after not receiving oxygenated blood for a prolonged period of time — was more associated with non-access-site major bleeding than access-site major bleeding (23 patients versus one) and stroke (12 patients versus one). 

Around one third of patients bled from the stomach, which Wong says may indicate the need for further research into how to prevent gastrointestinal bleeding among STEMI patients.

“Our findings are a clear indicator that non-access-site bleeding produced worse in-hospital outcomes, which could mean that we need to develop new approaches to prevent these bleeds.”
 

Researchers

Graham Wong

Related Articles

Early intervention with cryoablation for better heart outcomes

Keeping your head in the race: Cognitive impacts observed among ultra-marathon runners

Ask an expert: Now that I have been diagnosed with atrial fibrillation, what do I need to know to manage my heart health?

Share:

  • Facebook
  • Linkedin
  • Twitter
  • Email

Related Research Centres/Programs

Centre for Cardiovascular Innovation

Get the latest research headlines in your inbox

Subscribe

Recent News and Stories

Type
Participate in Research

Reaching for the stars: Virtual reality program creates new experiences for seniors in long-term care

Feb 3, 2023 participate, technology, mental health
Type
Announcement

VCHRI researchers awarded CIHR project grants to support health research

Feb 2, 2023
Type
Stories

Eye movements could be a window into brain health and function

Feb 1, 2023 brain, parkinsons, mobility
See more news

Get updates!

Join our newsletter mailing list to stay up to date on features and releases.

Subscribe

Quick Links

  • News and Stories
  • Careers
  • Events
  • Media Enquiries

Follow Us

  • Twitter
  • LinkedIn

© 2023 VCHRI. All rights reserved.

  • Contact
  • Privacy Policy