Death after PCI seen in just 0.5% of patients—heart attack, cardiac arrest most common causes
The risk of death following percutaneous coronary intervention (PCI) remains incredibly low, according to new findings published in The American Journal of Cardiology.[1] When it does occur, acute myocardial infarction (AMI), cardiac arrest and infection are two of the most common reasons.
“Estimating the risk of periprocedural mortality after percutaneous coronary intervention (PCI) is crucial for risk stratification and quality assessment,” wrote Dimitrios Strepkos, MD, a researcher with the Minneapolis Heart Institute Foundation, and colleagues.
Strepkos et al. examined data from the PROGRESS-COMPLICATIONS registry, focusing on more than 22,000 patients who underwent PCI from 2014 to 2024 at one of two high-volume U.S. facilities. The overall technical success rate was 78.3%. While 14.8% of patients underwent atherectomy as part of the procedure, 6.1% underwent intravascular lithotripsy.
A total of 115 patients—0.5% of the cohort—died during their index hospitalization. While 13% of those deaths occurred during the procedure, another 8.7% occurred within the first 24 hours. The remaining 78.3% of patients died after the first 24 hours.
The mean age of the patients who died was 72 years old and 62.6% were men. The mean BMI was 31.49 kg/m2. Common comorbidities included dyslipidemia (88.7%), chronic kidney disease (66.1%), heart failure (61.7%), peripheral artery disease (27.8%) and cerebrovascular disease (12.3%). In addition, 41.1% of the patients who died presented with a history of prior myocardial infarction and 37.4% presented with a history of prior PCI.
Stepkos et al. noted that common complications included bleeding events, stroke and cardiogenic shock. The primary causes of death after PCI were AMI (58.3%), cardiac arrest (6.1%), infection (6.1%) and aortic dissection (3.5%). The group also noted that “most deaths were an outcome of the severity of presentation and took place beyond the initial 24 hours from the PCI.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.