Clinical Outcomes of Comparison Between Type III Coronary Artery Perforation (CAP) and non-CAP Acute Coronary Syndrome Patients During 3-Year Follow-up

• Published in: Angiology 2025-01, Vol.76 (1), p.58-68
• Main Authors: Yildiz, Bekir S., Gunduz, Ramazan, Ozgur, Su, Cizgici, Ahmet Y., Ozdemir, Ibrahim H.
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Case-Control Studies; Coronary Angiography; Coronary Vessels - diagnostic imaging; Coronary Vessels - injuries; Female; Follow-Up Studies; Hospital Mortality; Humans; Male; Middle Aged; Percutaneous Coronary Intervention - adverse effects; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 0003-3197; 1940-1574; 1940-1574
• DOI: 10.1177/00033197231200029

Coronary artery perforation (CAP) is a potentially fatal complication of percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). This study aimed to investigate in-hospital, 1-year, and 3-year clinical outcomes of type III CAP during PCI in patients with ACS. The study retrospectively evaluated 118 patients with CAP and 43,226 case-control patients. Clinical, angiographic, and procedural characteristics, management, and outcomes were analyzed retrospectively at 1-year and 3-year follow-ups. The mean age of the patients was 66.5 ± 11.9 years (61.8% males). There was no significant difference in hospital mortality between the type III CAP and non-CAP groups. The all-cause mortality was 33.3% in the CAP group vs 1.8% in the non-CAP group at 1 year, and 28.3% in CAP group vs 6.9% in non-CAP group at 3 years (p = .001 for both comparisons). The procedural, clinical, and 1 and 3-year outcomes of type III CAP showed a relatively high risk of myocardial infarction, coronary artery bypass graft, cerebrovascular event, stent thrombosis, and major bleeding at the 1 and 3-year follow-ups. In addition, non-CAP ACS patients had better survival (log-rank: p < .001, 34.29 months 95% Confidence Interval [33.58–35.00]) than type III CAP ACS patients (29.53 months 95% Confidence Interval [27.28–31.78]) at the 3-year follow-up visit.