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Clinical Outcomes of Comparison Between Type III Coronary Artery Perforation (CAP) and non-CAP Acute Coronary

Bekir S Yildiz1, Ramazan Gunduz2, Su Ozgur3

  • 1Department of Cardiology, Celal Bayar University, Manisa, Turkey.

Angiology
|September 11, 2023
PubMed

Insights

Type III coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) significantly increases long-term mortality and adverse events, despite similar in-hospital survival compared to non-CAP patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Coronary artery perforation (CAP) is a serious complication of percutaneous coronary intervention (PCI).
  • Type III CAP, a severe form, poses significant risks during PCI for acute coronary syndrome (ACS).
  • Understanding long-term outcomes of type III CAP is crucial for patient management.

Purpose of the Study:

  • To evaluate the in-hospital, 1-year, and 3-year clinical outcomes of type III CAP in ACS patients undergoing PCI.
  • To compare outcomes between patients with type III CAP and a matched control group without CAP.
  • To identify specific adverse events associated with type III CAP post-PCI.

Main Methods:

  • Retrospective case-control study.
  • Inclusion of 118 patients with type III CAP and 43,226 control patients undergoing PCI for ACS.
  • Analysis of clinical, angiographic, procedural data, and follow-up outcomes at 1 and 3 years.

Main Results:

  • No significant difference in in-hospital mortality between type III CAP and non-CAP groups.
  • All-cause mortality at 1 year was 33.3% for CAP vs 1.8% for non-CAP; at 3 years, it was 28.3% vs 6.9% (p=.001).
  • Type III CAP patients experienced higher rates of myocardial infarction, coronary artery bypass graft, cerebrovascular events, stent thrombosis, and major bleeding at 1 and 3 years.

Conclusions:

  • Type III CAP during PCI for ACS is associated with significantly higher long-term all-cause mortality compared to non-CAP patients.
  • Patients with type III CAP face elevated risks of major adverse cardiovascular and cerebrovascular events, and bleeding up to 3 years post-procedure.
  • Improved survival was observed in non-CAP ACS patients compared to those with type III CAP at 3-year follow-up.

Keywords:
3-year follow-upacute coronary syndromecoronary artery perforation

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