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Title: Characteristics and outcomes of failed percutaneous coronary intervention in a contemporary Australian cohort.
Author: Biswas, S.
Dinh, D.
Brennan, A.
Tacey, M.
Andrianopoulos, Nick
Brien, R.
Haikerwal, D.
Toogood, G.
Oqueli, Ernesto
Cooke, J.
Warren, R.
Sapontis, J.
Wilson, A.
Hengel, C.
Reid, C.
Stub, D.
Leftkovits, J.
Issue Date: 2017
Conference Name: 65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting.
Conference Date: August 10th- 13th
Conference Place: Perth, Australia
Abstract: Background: With improvements in techniques and pharmacotherapy in percutaneous coronary intervention (PCI), more complex lesions are now being attempted. In the context of PCI performance assessment, there are limited data regarding the characteristics and outcomes of failed PCI. We therefore sought to examine failed PCI cases in a contemporary Australian cohort. Method: We prospectively collected data on 22,367 consecutive PCI procedures between 2013 and 2015 in the multi-centre Victorian Cardiac Outcomes Registry. Procedures were divided into 2 groups by whether or not PCI was deemed successful by the PCI operator at the end of the procedure. Results: 5.2% (n = 1173) of all PCI procedures were unsuccessful. In this group, patients were older (67.7 ± 11.4 vs. 65.4 ± 11.9 years), more likely to have peripheral or cerebrovascular disease, a history of previous PCI or coronary artery bypass surgery (CABG), severe left ventricular dysfunction and chronic kidney disease (all p < 0.05). They were also more likely to undergo an elective procedure and be treated at a private hospital (both p < 0.01). Chronic total occlusion PCI made up 31% of failed cases. Failed PCI was itself associated with higher in-hospital and 30-day mortality and MACE (all p < 0.01). 4.9% of failed PCIs led to unplanned in-hospital CABG (compared to 0.2% in successful PCIs, p < 0.01). Conclusion: Our study has characterised demographic and clinical characteristics associated with unsuccessful PCI attempts in a large patient cohort. Lack of procedural success has a strong influence on patient outcomes. Monitoring rates of failed cases among health services and operators is an important quality assurance tool.
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Internal ID Number: 01302
Type: Conference
Appears in Collections:Research Output

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