Evidence map›Paper›PMID 33840639›Full record

SynthesisEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2021

Mortality after bleeding versus myocardial infarction in coronary artery disease: a systematic review and meta-analysis.

Raffaele Piccolo, Angelo Oliva, Marisa Avvedimento, Anna Franzone, Stephan Windecker, Marco Valgimigli, Giovanni Esposito, Peter Jüni

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Impact of Mild Hypothermia As Adjunctive Therapy in Patients With ST-Elevation Myocardial Infarction: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Pooled it
  4. Pooled it
  5. Trial
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Observational
  12. The Prognostic Impact of Multiple Adverse Events on Long-Term Mortality Following Acute Myocardial Infarction.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Observational
  13. Article
  14. Review
  15. Article
  16. Article
  17. Antithrombotic therapy in complex percutaneous coronary intervention.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Review
  18. Observational
  19. One- versus three-month DAPT after everolimus-eluting stent implantation in diabetic patients at high bleeding risk: results from the XIENCE Short DAPT programme.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Raffaele PiccoloDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Angelo Oliva
Marisa Avvedimento
Anna Franzone
Stephan Windecker
Marco Valgimigli
Giovanni Esposito
Peter Jüni

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBleeding is the principal safety concern of antithrombotic therapy and occurs frequently among patients with coronary artery disease (CAD).

aimsWe aimed to evaluate the prognostic impact of bleeding on mortality compared with that of myocardial infarction (MI) in patients with CAD.

methodsWe searched Medline and Embase for studies that included patients with CAD and that reported both the association between the occurrence of bleeding and mortality, and between the occurrence of MI and mortality within the same population. Adjusted hazard ratios (HRs) for mortality associated with bleeding and MI were extracted and ratios of hazard ratios (rHRs) were pooled by using inverse variance weighted random effects meta-analyses. Early events included periprocedural or within 30-day events after revascularisation or acute coronary syndrome (ACS). Late events included spontaneous or beyond 30-day events after revascularisation or ACS.

resultsA total of 141,059 patients were included across 16 studies; 128,660 (91%) underwent percutaneous coronary intervention. Major bleeding increased the risk of mortality to the same extent as MI (rHRsbleedingvsMI 1.10, 95% CI: 0.71-1.71, p=0.668). Early bleeding was associated with a higher risk of mortality than early MI (rHRsbleedingvsMI 1.46, 95% CI: 1.13-1.89, p=0.004), although this finding was not present when only randomised trials were included. Late bleeding was prognostically comparable to late MI (rHRsbleedingvsMI 1.14, 95% CI: 0.87-1.49, p=0.358).

conclusionsCompared with MI, major and late bleeding is associated with a similar increase in mortality, whereas early bleeding might have a stronger association with mortality.

Indexed as

Acute Coronary SyndromeCoronary Artery DiseaseMyocardial InfarctionPercutaneous Coronary InterventionHemorrhageHumansTreatment Outcome

Identifiers

PMID33840639
PMCPMC9725060

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.