AI Article Synopsis
- Coronary perforation during acute coronary syndrome percutaneous coronary interventions (ACS-PCI) is rare, occurring in 0.37% of procedures, with consistent annual rates between 2007 and 2014.
- Key predictors of coronary perforation include older age, female gender, chronic total occlusion interventions, and the use of multiple stents or rotational atherectomy, while different P2Y12 inhibitors did not show a significant effect.
- The occurrence of coronary perforation is linked to worse clinical outcomes, and the use of glycoprotein inhibitors (GPI) is associated with increased rates of tamponade, highlighting the need for careful consideration of these factors in ACS-PCI procedures.
Article Abstract
Background: The evidence base for coronary perforation occurring during percutaneous coronary intervention in patients presenting with an acute coronary syndrome (ACS-PCI) is limited and the specific role of acute pharmacology in its clinical presentation unclear.
Methods And Results: Using the BCIS PCI database, data were analysed on all ACS-PCI procedures performed in England and Wales between 2007 and 2014. Multiple regressions were used to identify predictors of coronary perforation and its association with outcomes. Propensity score matching was used to evaluate the association between differing P2Y12 inhibitors or glycoprotein inhibitors (GPI) and CP. During 270,329 ACS-PCI procedures, 1013 coronary perforations were recorded (0.37%) with a stable annual incidence. In multiple regression analysis, covariates associated with increased frequency of coronary perforation included age, female gender, CTO intervention, number and length of stents used, and rotational atherectomy use, whilst differing P2Y12 inhibitors were not predictive. Using propensity score matching, use of a GPI was independently associated with tamponade (OR 1.50, [1.08-2.06], p = 0.014). The adjusted odds ratios for all clinical outcomes were adversely affected by coronary perforation.
Conclusions: Coronary perforation is an infrequent event during ACS-PCI but is closely associated with adverse clinical outcomes. GPI use was associated with higher rates of tamponade.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2019.06.034 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
PDA-associated infective endocarditis with pulmonary artery perforation.
Pak J Med Sci
January 2025
Muhammad Ali Mumtaz, MD FACS. Tahir Heart Institute, Fazl-e-Omar Hospital, Chenab Nagar, District Chiniot, Pakistan.
Infective endocarditis used to frequently cause mortality in subjects having PDA before the advent of antibiotics and surgical ligation. It has been documented that clinically silent PDAs may cause infective complications of heart valves. We present case of an 18-years-old male who presented with palpitations and fever to our emergency department.
View Article and Find Full Text PDFInvestigation of the Feasibility and Safety of a Highly Intensive Penetration Technique for Recanalization in Severe Calcified Femoropopliteal Occlusive Lesions: A Retrospective Observational Study.
Health Sci Rep
January 2025
Department of Cardiology Saiseikai Yokohama City Eastern Hospital Kanagawa Japan.
Background And Aims: When dealing with severely calcified lesions in endovascular therapy (EVT) for lower extremity artery disease (LEAD), navigating through severely calcified chronic total occlusion (CTO) using hard-tip guidewires can be challenging. To address this issue, we employed a novel highly intensive penetration (HIP) technique. This technique involves modifying the tail of a 0.
View Article and Find Full Text PDFCardiac Tamponade Due to Right Ventricle Perforation: A Rare Complication of Catheter Ablation for Ventricular Tachycardia Storm.
Acta Med Indones
October 2024
Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Cardiac tamponade is a rare but fatal complication of catheter ablation. We are reporting a case of a 73-year-old male with ventricular tachycardia (VT) storm undergoing urgent VT ablation, who was later found to have right ventricle (RV) perforation-an unusual site for catheter ablation complication. The patient underwent isochronal late activation mapping (ILAM)-based ablation and elimination of local abnormal ventricular activities (LAVA).
View Article and Find Full Text PDFPermanent Left Bundle Branch Area DF-4 Defibrillator Lead Implantation-Feasibility, Procedural Caveats, Safety, and Follow-Up.
J Cardiovasc Electrophysiol
January 2025
Department of Cardiac Electrophysiology and Pacing, Arrhythmia Heart Failure Academy, The Madras Medical Mission, Chennai, Tamil Nadu, India.
Introduction: Permanent implantation of a DF-4 implantable cardiac defibrillator (ICD) lead in the left bundle branch area (LBBA-ICD) is the next paradigm in amalgamating cardiac resynchronization therapy (CRT) and defibrillation. We systematically investigated feasibility/success rate, procedural caveats, and complications associated with a permanent DF-4 LBBA ICD implant and pertinent data at short-term follow-up.
Methods: We prospectively attempted implantation of 7 Fr Durata (Abbott, Chicago, IL, USA) single coil DF-4 ICD lead at the LBBA using a fixed-curve non-deflectable CPS locator delivery sheath.
[Utility of CT Cardiac Angiography in the Evaluation of Infective Endocarditis and Its Complications].
Rev Med Chil
September 2024
Hospital Dr. Hernán Henríquez Aravena, Universidad de la Frontera, Temuco, Chile.
Infective endocarditis (IE) is an infection that affects the heart valves, endocardium, and great vessels. It has a mortality rate of approximately 30% per year, so early diagnosis is essential to reduce morbidity and mortality. Cardiac angio-CT triggered by electrocardiogram (ECG) has been considered in IE management guidelines in recent years, given its high spatial resolution, contributing to the diagnosis and evaluation of valvular complications (vegetations, perforations, dysfunctions), perivalvular (abscesses, pseudoaneurysms, prosthesis dehiscence, fistulas) and compromised coronary arteries (embolism), allowing early diagnosis and treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!