In-hospital mortality and complications after coronary angioplasty, City of Rio de Janeiro, Southeastern Brazil

Complications after elective percutaneous coronary interventions: A comparison between public and private hospitals

OBJECTIVE

Complications after percutaneous coronary interventions (PCI) are associated with significant morbidity and mortality, although institutional discrepancies can occur when public and private hospitals coexist within the healthcare system. The aim of this study was to compare the in-hospital complication rates and mortality in addition to long-term survival following elective PCI in two reference public and private cardiology hospitals in Rio de Janeiro, Brazil.

METHODS

From January 1st 2013 to December 31st 2014, a total of 440 procedures were identified in both hospitals (public: 328 vs. private: 112) and retrospectively analyzed by chart review.

RESULTS

There were no significant differences between the two hospitals regarding the total number of procedures with at least one complication (public: 23.8 vs. private: 17.9%, p=0.2) or in-hospital mortality rates (public: 0.6% vs. private: 0%, p=0.5). Post-procedural renal insufficiency was more frequent in the private hospital, whereas coronary-related complications were more prevalent in the public hospital. After a mean follow up of 30.3 months (SD±9.2), the survival rate was also similar.

CONCLUSIONS

Clinical complications after elective PCI are common both in public and private hospitals. Meticulous pre-procedural clinical assessment and patient selection as well as adherence to guideline-based practices could minimize the risk of PCI-related adverse events.

Troponin I elevation after elective percutaneous coronary interventions: Prevalence and risk factors

Troponin elevation after coronary angioplasty is a prognostic marker associated with significant morbidity and mortality, although its prevalence varies according to clinical and procedural characteristics. We analyzed the frequency of post-procedural enzyme elevation among 112 elective interventions between 2013 and 2014 in a private hospital in Brazil. Troponin increase was observed in 62.5% of the procedures, and was related to age, female sex, low pre-procedural hemoglobin, prior angiotensin converting enzyme inhibitor or angiotensin receptor blocker use and multivessel angioplasty. PCI is not a risk free procedure and these results underscore the importance of a careful clinical assessment before its utilization.