Matic, Dragan M (25959220100)Dragan M (25959220100)MaticAsanin, Milika R (8603366900)Milika R (8603366900)AsaninVukcevic, Vladan D (15741934700)Vladan D (15741934700)VukcevicMehmedbegovic, Zlatko H (55778381000)Zlatko H (55778381000)MehmedbegovicMarinkovic, Jelena M (7004611210)Jelena M (7004611210)MarinkovicKocev, Nikola I (6602672952)Nikola I (6602672952)KocevMarjanovic, Marija M (56437423000)Marija M (56437423000)MarjanovicMrdovic, Igor B (10140828000)Igor B (10140828000)MrdovicAntonijevic, Nebojsa M (6602303948)Nebojsa M (6602303948)AntonijevicMilosevic, Aleksandra D (56622640900)Aleksandra D (56622640900)MilosevicZivkovic, Milorad N (55959530600)Milorad N (55959530600)ZivkovicKrljanac, Gordana V (8947929900)Gordana V (8947929900)KrljanacStankovic, Sanja Dj (7005216636)Sanja Dj (7005216636)StankovicMilasinovic, Dejan G (24823024500)Dejan G (24823024500)MilasinovicLasica, Ratko M (14631892300)Ratko M (14631892300)LasicaStankovic, Goran R (59150945500)Goran R (59150945500)Stankovic2025-06-122025-06-122019https://doi.org/10.1136/heartjnl-2019-314728https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066895860&doi=10.1136%2fheartjnl-2019-314728&partnerID=40&md5=379858999154d2f2ff2168a7ad8c51d0https://remedy.med.bg.ac.rs/handle/123456789/5359Objectives The influence of the bleeding site on long-term survival after the primary percutaneous coronary intervention (PCI) is poorly understood. This study sought to investigate the relationship between in-hospital access site versus non-access site bleeding and very late mortality in unselected patients treated with primary PCI. Methods Data of the 2715 consecutive patients with ST-segment elevation myocardial infarction treated with primary PCI, enrolled in a prospective registry of a high volume tertiary centre, were analysed. Bleeding events were assessed according to the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 4-year mortality. Results The BARC type ≥2 bleeding occurred in 171 patients (6.3%). Access site bleeding occurred in 3.8%, and non-access site bleeding in 2.5% of patients. Four-year mortality was significantly higher for patients with bleeding (BARC type ≥2) than in patients without bleeding (BARC type 0+1), (36.3% vs 16.2%, p<0.001). Patients with non-access site bleeding had higher 4 year mortality (50.7% vs 26.5%, p=0.001). After multivariable adjustment, BARC type ≥2 bleeding was the independent predictor of 4 year mortality (HR 2.01; 95% CI 1.49 to 2.71, p<0.001). Patients with a non-access site bleeding were at 2-fold higher risk of very late mortality than patients with an access site bleeding (HR 2.62; 1.78 to 3.86, p<0.001 vs HR 1.57; 1.03 to 2.38, p=0.034). Conclusions Both access and non-access site BARC type ≥2 bleeding is independently associated with a high risk of 4-year mortality after primary PCI. Patients with non-access site bleeding were at higher risk of late mortality than patients with access site bleeding. © 2019 Author(s) (or their employer(s)).acute myocardial infarctionpercutaneous coronary intervention