Do complications during percutaneous coronary intervention affect outcome ?

The authors studied whether complications during a percutaneous coronary intervention affects outcome in patients. The authors concluded that intra-procedural thrombotic events are associated with greater mortality and other events during hospitalization, 30 days after hospitalization and in the long-term.

Percutaneous coronary intervention is a non-surgical procedure used to treat the narrowed coronary arteries of the heart. Complications like intra-procedural thrombotic events can occur. Examples of these events include slow blood flow, no blood reflow, blood clots, sudden closure of blood vessels and stent thrombosis (blood clot due to stent). It is suggested that intra-procedural thrombotic events can influence the outcome of a percutaneous coronary intervention.

The authors looked at 11 studies that compared patients who had an intra-procedural thrombotic events with patients who did not. Of 26,697 patients who underwent percutaneous coronary intervention, 1572 patients had intra-procedural thrombotic events.

In the hospital, patients who had an intra-procedural thrombotic event were 5.36 times more likely to not survive. They were 4.96 times more likely to have a heart attack. They were 2.23 times more likely to have major bleeding.

30 days after the procedure, patients who had an intra-procedural thrombotic event were 4.57 times more likely to not survive. They were 4.11 times more likely to have a heart attack. They were 2.3 times more likely to require another procedure to allow blood to flow. They were 3.22 times more likely to have a blood clot due to the stent placement (mesh wire tube placed in blood vessel).

In the long-term, patients with intra-procedural thrombotic event were 2.19 times more likely to not survive compared to patients who did not have an event.

Among patients who had an intra-procedural thrombotic event, stent thrombosis was associated with a greater risk of heart attack compared to both no blood reflow and blood clots. 

The authors concluded that intra-procedural thrombotic events are associated with greater mortality and other events, during the index hospitalization, at 30 days and long-term.