Multiple factors linked to greater risk of ‘catastrophic’ PCI complication
Intraprocedural cardiac arrest (IPCA) still occurs during nearly 1% of percutaneous coronary intervention (PCI) procedures, according to new findings published in JACC: Cardiovascular Interventions.[1]
Hoping to learn more about IPCA during PCI, researchers tracked years of data from the CathPCI Registry. The group’s goal was to study trends over time and see what else can be learned about this potentially fatal complication.
“As IPCA can have catastrophic consequences, it is imperative to understand what factors predict its incidence, understand factors which can be helpful in prevention, and develop improved workflows to ensure the response can be swift, organized and efficacious,” wrote first author Ramya C. Mosarla, MD, an interventional cardiologist with NYU Langone Health, and colleagues.
The group focused on data from more than 3.9 million PCI procedures performed from 2018 to 2023. The overall IPCA rate was 0.93%. Elective PCIs, PCIs for stable coronary artery disease, and PCIs for acute coronary syndrome interventions were associated with IPCA rates of 0.24%, 0.32% and 1.28%, respectively.
IPCA during PCI became slightly more common from 2018 (0.62%) to 2023 (1.07%), but the rate of risk-adjusted death after IPCA actually decreased over the course of the study.
One key takeaway from the group’s analysis was the number of specific patient characteristics associated with an increased risk of IPCA during PCI. This included advanced age, ventricular arrhythmias, severe aortic stenosis, the use of vasopressors or inotropes, coronary perforation, coronary dissection, cardiac tamponade, heart failure and temporary pacemaker placement.
“Although several patient and procedural risk factors appear to be independently associated with IPCA, few are modifiable,” the authors wrote. “Still, the findings in the present study are valuable in that they may inform case selection for PCI and risk-benefit conversations with patients, particularly among those with elective indications for coronary revascularization focused on improving quality of life.”
Click here to read the full analysis in JACC: Cardiovascular Interventions, an American College of Cardiology journal.
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.