Who die after PCI:Re-assessment of in-hospital death cases

YANG Jun-qing

摘要：Background In-hospital(IH)mortality for patients underwent percutaneous coronary intervention(PCI)in our center from 1994 to 2004 was 1.01%(33/3 252).The PCI volume in our state increased quickly during the last few years,so did it in our center. Methods and ResultsWe retrospectively screened a total of 3 274 cases who underwent PCI in 2009,among which 24(0.73%,P＝0.22vs.1994-2004)IH death occurred.Analysis of these 24 cases revealed that all of them were diagnosed as acute coronary syndrome (ACS),and had the indication of PCI.Fifteen(63%)carried a chance of≥10% to die in hospital according to GRACE model. Significant left-main(LM)and/or triple-vessel disease(TVD)were defined in 21(88%)cases. SYNTAX scores were≥23 in 15(63%)and≥33 in 12(50%)cases. Complete revascularization with PCI was fulfilled in only 5(21%)cases. Myocardial ischemia or heart function couldn't improve by PCI was the most frequent cause of death,which contributed to that of 11(46%)cases.Cardiac repture occurred in all of the 4patients with ST elevated acute myocardial infarction(STE-AMI)involving inferior ventricular wall but "reserved" anterior wall, and contributed mainly to their mortality. Conclusions Post-PCI IH mortality has maintained low in our center.It most likely occurs in patients with ACS.The major cause of death is that myocardial ischemia couldn't improve by PCI,except for patients with inferior but no anterior myocardial infarction, who suffer from cardiac rupture instead.