Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Coronary artery perforation and tamponade : Incidence, risk factors, predictors and outcomes from 12 years' data of the SCAAR registry

Harnek, Jan LU ; James, Stefan and Lagerqvist, Bo (2020) In Circulation Journal 84(1). p.43-53
Abstract

Background: The incidence and short- and long-term outcomes of coronary artery perforation (CAP) are not well described. Methods and Results: We analyzed the characteristics and the short- and long-term outcomes of CAP among 243,149 patients undergoing percutaneous coronary interventions (PCI) from 2005 until 2017 in the national Swedish registry. We identified 1,008 cases of CAP with an incidence of 0.42%. Major adverse event rates were significantly higher in patients with CAP than non-CAP (P<0.001). The 1-year mortality rate was 16% vs. 5.5%, respectively, and the 12-year mortality rate was 52% vs. 34%. The restenosis rate was 5.2% vs. 3.1% and 17% vs. 9%, respectively. The target lesion revascularization rate was 4.2% vs. 2.6%... (More)

Background: The incidence and short- and long-term outcomes of coronary artery perforation (CAP) are not well described. Methods and Results: We analyzed the characteristics and the short- and long-term outcomes of CAP among 243,149 patients undergoing percutaneous coronary interventions (PCI) from 2005 until 2017 in the national Swedish registry. We identified 1,008 cases of CAP with an incidence of 0.42%. Major adverse event rates were significantly higher in patients with CAP than non-CAP (P<0.001). The 1-year mortality rate was 16% vs. 5.5%, respectively, and the 12-year mortality rate was 52% vs. 34%. The restenosis rate was 5.2% vs. 3.1% and 17% vs. 9%, respectively. The target lesion revascularization rate was 4.2% vs. 2.6% and 10.5% vs. 7%. The stent thrombosis rate was numerically higher, 1.5% vs. 0.8% and 4.5 vs. 2.8%, with no stent thrombosis cases for equine pericardial stent grafts. Among the patients with tamponade a large proportion of cases occurred at the late stage (215/1,008, 21%), and most were not recognized in the cath-lab (167/215, 78%). The mortality rate for late tamponade was similar in patients suffering acute tamponade at 1 year (25.6% vs. 27%) or at 12 years (54% vs. 58%). Conclusions: CAP is associated with an early high excess in morbidity and mortality but with low risk of additional adverse events in the long term. Late tamponade is as deadly as acute tamponade.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Coronary complications, Coronary perforation, Percutaneous coronary intervention, Tamponade
in
Circulation Journal
volume
84
issue
1
pages
11 pages
publisher
Japanese Circulation Society
external identifiers
  • scopus:85077221858
  • pmid:31813890
ISSN
1346-9843
DOI
10.1253/circj.CJ-19-0757
language
English
LU publication?
yes
id
0f92496d-36f8-48d3-868f-695abd9bae25
date added to LUP
2020-01-10 12:46:53
date last changed
2024-07-11 11:26:53
@article{0f92496d-36f8-48d3-868f-695abd9bae25,
  abstract     = {{<p>Background: The incidence and short- and long-term outcomes of coronary artery perforation (CAP) are not well described. Methods and Results: We analyzed the characteristics and the short- and long-term outcomes of CAP among 243,149 patients undergoing percutaneous coronary interventions (PCI) from 2005 until 2017 in the national Swedish registry. We identified 1,008 cases of CAP with an incidence of 0.42%. Major adverse event rates were significantly higher in patients with CAP than non-CAP (P&lt;0.001). The 1-year mortality rate was 16% vs. 5.5%, respectively, and the 12-year mortality rate was 52% vs. 34%. The restenosis rate was 5.2% vs. 3.1% and 17% vs. 9%, respectively. The target lesion revascularization rate was 4.2% vs. 2.6% and 10.5% vs. 7%. The stent thrombosis rate was numerically higher, 1.5% vs. 0.8% and 4.5 vs. 2.8%, with no stent thrombosis cases for equine pericardial stent grafts. Among the patients with tamponade a large proportion of cases occurred at the late stage (215/1,008, 21%), and most were not recognized in the cath-lab (167/215, 78%). The mortality rate for late tamponade was similar in patients suffering acute tamponade at 1 year (25.6% vs. 27%) or at 12 years (54% vs. 58%). Conclusions: CAP is associated with an early high excess in morbidity and mortality but with low risk of additional adverse events in the long term. Late tamponade is as deadly as acute tamponade.</p>}},
  author       = {{Harnek, Jan and James, Stefan and Lagerqvist, Bo}},
  issn         = {{1346-9843}},
  keywords     = {{Coronary complications; Coronary perforation; Percutaneous coronary intervention; Tamponade}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{43--53}},
  publisher    = {{Japanese Circulation Society}},
  series       = {{Circulation Journal}},
  title        = {{Coronary artery perforation and tamponade : Incidence, risk factors, predictors and outcomes from 12 years' data of the SCAAR registry}},
  url          = {{http://dx.doi.org/10.1253/circj.CJ-19-0757}},
  doi          = {{10.1253/circj.CJ-19-0757}},
  volume       = {{84}},
  year         = {{2020}},
}