PREDICTORS OF SUCCESS AND MAJOR COMPLICATIONS FOR PRIMARY PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN ACUTE MYOCARDIAL-INFARCTION - AN ANALYSIS OF THE 1990 TO 1994 SOCIETY FOR CARDIAC ANGIOGRAPHY AND INTERVENTIONS REGISTRIES

Objectives. The purpose of this study was to determine predictors of s uccessful coronary angioplasty for acute myocardial infarction (MI) an d associated predictors of the major complications of in-hospital mort ality and emergency coronary artery bypass graft surgery. Background. Primary angioplasty is being increasingly used to treat acute MI, but factors affecting the success and major complications have not been we ll studied. Forty laboratories have been contributing clinical and pro cedural data to the Society of Cardiac Angiography and Interventions ( SCA&I) an primary angioplasty far acute MI. Methods. Univariable and s tepwise multivariable logistic regression analysis of clinical and pro cedural variables was used to calculate predictors of success and majo r complications. Results. There were 4,366 primary angioplasty procedu res reported from 1990 through 1994, with an overall success rate of 9 1.5%, an in-hospital mortality rate of 2.5% and a rate of emergency su rgery of 4.3%. Higher laboratory primary angioplasty volume and lower age were predictive of success. An intraaortic balloon pump in place, cardiogenic shock and a moribund condition had negative predictive eff ects. Unsuccessful angioplasty, cardiogenic shock or a moribund state were predictive of in-hospital death, Unsuccessful angioplasty, the ab sence of a history of hypertension and the absence of congestive heart failure were predictive of emergency surgery. Conclusions. The rates of success and major complications in the SCA&I Registry are similar t o other series. Predictors of success and major complications can be a ssessed and may be useful for risk stratifying candidates for primary angioplasty in acute MI. (C) 1997 by the American College of Cardiolog y.