TY - JOUR
T1 - Characteristics and outcomes of unsuccessful percutaneous coronary intervention
AU - Biswas, Sinjini
AU - Dinh, Diem
AU - Duffy, Stephen J.
AU - Brennan, Angela
AU - Liew, Danny
AU - Chan, William
AU - Cox, Nicholas
AU - Reid, Christopher M.
AU - Lefkovits, Jeffrey
AU - Stub, Dion
N1 - Funding Information:
Dr. Sinjini Biswas is supported by scholarships from the National Heart Foundation (NHF) of Australia (reference no. 101518), National Health and Medical Research Council of Australia (NHMRC) Cardiovascular Centre of Research Excellence in Cardiovascular Outcomes Improvement (CRE-COI), and the Australian Government Research Training Program. Professor Stephen J. Duffy's work is supported by a NHMRC grant (reference no. 1111170). Professor Christopher M. Reid is supported by a NHMRC Principal Research Fellowship (reference no. 11136372). Associate Professor Dion Stub is supported by a NHF Future Leader Fellowship (reference no. 101908).
Funding Information:
Dr. Sinjini Biswas is supported by scholarships from the National Heart Foundation (NHF) of Australia (reference no. 101518), National Health and Medical Research Council of Australia (NHMRC) Cardiovascular Centre of Research Excellence in Cardiovascular Outcomes Improvement (CRE‐COI), and the Australian Government Research Training Program. Professor Stephen J. Duffy's work is supported by a NHMRC grant (reference no. 1111170). Professor Christopher M. Reid is supported by a NHMRC Principal Research Fellowship (reference no. 11136372). Associate Professor Dion Stub is supported by a NHF Future Leader Fellowship (reference no. 101908).
Funding Information:
National Health and Medical Research Council of Australia, Grant/Award Number: 1111170; National Heart Foundation of Australia, Grant/Award Number: 101518; NHF Future Leader Fellowship, Grant/Award Number: 101908; NHMRC Principal Research Fellowship, Grant/Award Number: 11136372; Australian Government Research Training Program; Cardiovascular Centre of Research Excellence in Cardiovascular Outcomes Improvement Funding information
Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2022/2/15
Y1 - 2022/2/15
N2 - 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.
AB - 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.
KW - clinical outcomes
KW - percutaneous coronary intervention
KW - registry
UR - http://www.scopus.com/inward/record.url?scp=85111996337&partnerID=8YFLogxK
U2 - 10.1002/ccd.29886
DO - 10.1002/ccd.29886
M3 - Article
C2 - 34331500
AN - SCOPUS:85111996337
SN - 1522-1946
VL - 99
SP - 609
EP - 616
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 3
ER -