Abstract |
Coronary perforation (CP) is a life-threatening complication that can occur during percutaneous coronary intervention (PCI). Little is known, however, about the incidence and clinical outcome of CP. We sought to investigate the occurrence of CP and its determinants and risk profile in a large-scale, prospective registry. From 2005 to 2008, unselected patients (n = 42,068) from 175 centers in 33 countries who underwent a PCI procedure were prospectively enrolled in the PCI registry of the Euro Heart Survey program. For the present analysis, patients experiencing CP during PCI (n = 124, 0.3%) were compared with those who underwent PCI without CP. Patients with CP were older, more often women, had more severe coronary disease, and underwent more complex types of coronary intervention. Independent factors associated with CP were the use of rotablation, intravascular ultrasound-guided PCI, bypass PCI, a totally occluded vessel, a type C lesion, peripheral arterial disease, and body mass index <25. More than 10% of the patients developed cardiac tamponade. In a small minority (3.3%), emergency bypass surgery had to be performed. The inhospital death rate was markedly elevated in patients with CP (7.3% vs 1.5%, p <0.001). After adjustment for the EuroHeart score, CP remained a strong predictor of hospital mortality (odds ratio 5.21, 95% confidence interval 2.34 to 11.60). In conclusion, in this real world, all-comers registry, the incidence of CP was low, occurred more often in patients who underwent more complex coronary interventions, and was associated with a fivefold higher hospital mortality.
|
Authors | Timm Bauer, Niklas Boeder, Holger M Nef, Helge Möllmann, Matthias Hochadel, Jean Marco, Franz Weidinger, Uwe Zeymer, Anselm K Gitt, Christian W Hamm |
Journal | The American journal of cardiology
(Am J Cardiol)
Vol. 116
Issue 9
Pg. 1363-7
(Nov 01 2015)
ISSN: 1879-1913 [Electronic] United States |
PMID | 26341189
(Publication Type: Comparative Study, Journal Article, Multicenter Study)
|
Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Body Mass Index
- Cardiac Tamponade
(etiology)
- Coronary Artery Disease
(surgery)
- Coronary Vessels
(injuries)
- European Union
(statistics & numerical data)
- Female
- Hospital Mortality
- Humans
- Incidence
- Male
- Middle Aged
- Percutaneous Coronary Intervention
(adverse effects, mortality)
- Prospective Studies
- Registries
- Risk Assessment
- Risk Factors
- Treatment Outcome
|