Background
Failed percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (MI) is associated with adverse outcome. With recent improvements in PCI techniques, it is unclear what are the incidence and predictors for failed primary PCI. The objective of this study was to determine the outcome and predictors of patients who failed primary PCI after MI.
Results
Of 2900 patients, 111 (3.98%) had failed PCI. As shown in the Table 1 , patients who had failed PCI were older and were likely to be women, to have PVD, to have previous PCI, or to present with cardiogenic shock. Multivariable logistic regression analysis identified female gender (OR 1.54; 95% CI 1.01–2.38), cardiogenic shock (2.07; 1.22–3.49), previous PCI (1.71; 1.08–2.70), and type-C lesion (2.47; 1.60–3.82) as independent predictors PCI failure. The in-hospital and long-term mortality was significantly higher in the failed PCI group as compared to the successful group.
| Variable n =2900 | Failed PCI n =111 | Successful PCI n =2789 | P value |
|---|---|---|---|
| Age (years±S.D.) | 65±15 | 61±13 | .003 |
| Women | 46% | 32% | .002 |
| PVD | 18% | 11% | .02 |
| Previous PCI | 29% | 20% | .02 |
| Cardiogenic shock | 25% | 11% | <.001 |
| All-cause mortality | |||
| In-hospital | 18% | 4% | <.001 |
| 30-day | 35% | 7% | <.001 |
| 1-year | 48% | 14 | <.001 |
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