Complications and Associated Risk Factors of Percutaneous Coronary Intervention: A Comparative Study Between Primary and Elective Patients
Keywords:
Myocardial infarction, Angiography, Angioplasty, Percutaneous coronary intervention, Primary PCI, Elective PCIAbstract
Objective: To compare the complications and associated risk factors between primary and elective percutaneous coronary intervention (PCI) among patients attending emergency department of a tertiary care hospital, Karachi, Pakistan.
Methods: This retrospective cross-sectional study was conducted at Dr. Ziauddin University Hospital, Clifton campus, Karachi, from April 2019 to March 2021. All patients who underwent elective or primary PCI over the age of 18 years were included. The complications such as hypotension, coronary dissection, no-reflow, coronary perforation, arrhythmias, cardiac tamponade, stent thrombosis, and in-hospital death were observed. These complications were followed up till one month after the PCI.
Results: Of total 155 patients, the mean age was 60.77 ± 11.15 years. There were 104 (67.1%) males and 51 (32.9%) females. Primary PCI was performed among 103 (66.5%) patients and elective PCI in 52 (33.5%) patients. Complications of PCI was observed in 94 (60.6%) patients. The most common complication presented was no-reflow 31 (32.9%). However, 14 (14.8%) patients presented with hypotension and 10 (10.5%) with hypotension along with no-reflow. Complications were found to be significantly higher in primary PCI 76 (73.8%) as compared to elective PCI 18 (34.6%) (p-value <0.001). Furthermore, mortality rate among primary PCI was found significantly higher as compared to elective PCI i.e., 13 (92.9%) vs. 1 (7.1%) (p-value 0.036).
Conclusion: No-reflow, hypotension and hypotension along with no-reflow are a frequent complication of PCI especially when the patients undergo primary PCI as compared to elective intervention.
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Copyright (c) 2022 Dr Ghulam Hussain Soomro, Fatima Iqbal Hussain, Dr Mahnoor Ali, Dr Uraza Noor, Dr Zainab Aslam Saeed Memon, Dr Nasir Yaqoob
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