Impact of intraprocedural thrombotic events on short- and long-term outcomes following percutaneous coronary intervention. Evidence from a meta-analysis

Int J Cardiol. 2016 Jan 1:202:469-76. doi: 10.1016/j.ijcard.2015.09.030. Epub 2015 Sep 26.

Abstract

Background: Data regarding the effects of intraprocedural thrombotic events (IPTE) are scarce. Hence we aim to perform a meta-analysis to examine the outcomes of IPTE compared to non-IPTE during PCI.

Methods: We performed a literature search of all published full-length articles of studies that reported data on patients with IPTE compared with non-IPTE during PCI. We calculated odd ratios via random effects model.

Results: A total of 26,697 patients, of which 1572 patients had IPTE, were included in this analysis. In-hospital, IPTE was associated with higher mortality (odds ratio (OR) 5.36, 95% confidence interval (CI) [2.31, 12.41]; p<0.0001), myocardial infarction (MI) and major bleeding compared to non-IPTE. At 30 days, IPTE was also associated with higher mortality (OR 4.57, 95% CI [2.43, 8.60]; p<0.0001), MI, repeat revascularization, stent thrombosis and major bleeding compared to non-IPTE group. IPTE was also associated with higher long-term mortality (OR 2.19, 95% CI [1.35, 3.53]; p=0.001). Among IPTE patients, intraprocedural stent thrombosis was associated with greater odds of MI compared to both no reflow and distal embolization events.

Conclusion: IPTE during PCI is associated with more adverse ischemic events, including mortality, during the index hospitalization, at 30 days and long-term.

Keywords: Distal embolization; Intraprocedural thrombotic events; No reflow; PCI.

Publication types

  • Meta-Analysis

MeSH terms

  • Acute Coronary Syndrome / surgery
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intraoperative Complications / epidemiology
  • Intraoperative Complications / etiology
  • Intraoperative Complications / mortality
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / methods
  • Percutaneous Coronary Intervention / statistics & numerical data*
  • Stents / adverse effects
  • Thrombosis / epidemiology*
  • Thrombosis / etiology
  • Thrombosis / mortality
  • Treatment Outcome