Characteristics and outcomes of unsuccessful percutaneous coronary intervention

Biswas, S.; Dinh, D.; Duffy, S.J.; Brennan, A.; Liew, D.; Chan, W.; Cox, N.; Reid, Christopher; Lefkovits, J.; Stub, D.

doi:10.1002/ccd.29886

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Access Status

Open access

Authors

Biswas, S.

Dinh, D.

Duffy, S.J.

Brennan, A.

Liew, D.

Chan, W.

Cox, N.

Reid, Christopher

Lefkovits, J.

Stub, D.

Date

2022

Type

Journal Article

Metadata

Show full item record

Citation

Biswas, S. and Dinh, D. and Duffy, S.J. and Brennan, A. and Liew, D. and Chan, W. and Cox, N. et al. 2022. Characteristics and outcomes of unsuccessful percutaneous coronary intervention. Catheterization and Cardiovascular Interventions. 99 (3): pp. 609-616.

Source Title

Catheterization and Cardiovascular Interventions

DOI

10.1002/ccd.29886

ISSN

1522-1946

Faculty

Faculty of Health Sciences

School

Curtin School of Population Health

Funding and Sponsorship

http://purl.org/au-research/grants/nhmrc/1111170

Remarks

This is the peer reviewed version of the following article: Biswas, S, Dinh, D, Duffy, SJ, Brennan, A, Liew, D, Chan, W, et al. Characteristics and outcomes of unsuccessful percutaneous coronary intervention. Catheter Cardiovasc Interv. 2021; 99: 609–616, which has been published in final form at https://doi.org/10.1002/ccd.29886. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

URI

http://hdl.handle.net/20.500.11937/93109

Collection

Curtin Research Publications

Abstract

Objectives: To examine predictors and outcomes of unsuccessful percutaneous coronary intervention (PCI) cases in a contemporary Australian registry cohort. Background: With improvements in techniques and pharmacotherapy in PCI, more complex lesions in older patients are now being attempted. In the context of PCI performance assessment, there are limited data regarding the characteristics and outcomes of unsuccessful PCI. Method: We prospectively collected data on patients undergoing single-lesion PCI between 2013 and 2017 who were enrolled in the multi-center Victorian Cardiac Outcomes Registry. Procedures were divided into two groups by whether or not PCI was deemed successful at the end of the procedure using a pre-specified definition. Results: There were 34,383 single-lesion PCI performed, of which 18,644 (54.2%) were for acute coronary syndromes. Of the study cohort, 2080 patients (6.0%) had an unsuccessful PCI – these patients were older, more likely to have previous stroke, PCI, severe left ventricular dysfunction and chronic kidney disease (all p < 0.001). The procedure was also more likely to be performed for stable angina (p < 0.001). Chronic total occlusion PCI made up 31% of unsuccessful PCI cases. Unsuccessful PCI was itself associated with higher in-hospital and 30-day mortality and MACE (all p < 0.001). 4.9% of unsuccessful PCIs led to unplanned in-hospital bypass surgery (compared to 0.2% in successful PCIs, p < 0.001). Conclusion: Our study highlights that even in contemporary PCI practice, more than 1 in 20 PCI attempts are unsuccessful. Lack of procedural success has a strong influence on patient outcomes. Monitoring rates of unsuccessful cases is an important quality assurance tool.