Predictors of In-Hospital Adverse Events after PCI for NSTEMI in the National Percutaneous Coronary Intervention (PCI) Registry
Nattawut Wongpraparut MD*, Pradit Panchavinnin MD*, Damras Tresukosol MD*, Chunhakasem Chotinaiwattarakul MD**, Rewat Phankingthongkum MD*, Wiwun Tungsubutra MD*, Rungtiwa Pongakasira BSc***, Khemajira Karaketklang MPH****, on behalf of Thailand National PCI Registry
Affiliation : * Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand ** Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand *** Research Division, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand **** Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Objective : Evaluate the in-hospital major adverse cardiovascular events (MACE) and clinical predictors of non-ST-T MI
that undergoing percutaneous coronary interventions (PCI) in Thailand.
Material and Method: Thailand National PCI Registry enrolled 4,156 patients that underwent PCI in Thailand between
May 1 and October 31, 2006. Four hundred eighty three patients underwent PCI with indication of non-ST-T MI. Baseline
demographic and angiographic characteristic were recorded. MACE included CV death, MI, and stroke.
Results : In-hospital MACE occurred in 27 patients (5.6%), included CV death in 15 patients (3.1%), MI in 14 patients
(2.9%), and stroke in 2 patients (0.4%). In-hospital MACE were higher in patients with previous history of CABG
(19.2% versus 4.8%, p = 0.01), cardiogenic shock at presentation (29.3% versus 3.4%, p<0.001), significant left main
disease (19.4% versus 4.6%, p = 0.005), baseline ejection fraction <30% (25% versus 4.4%, p = 0.003), and used of
intra-aortic balloon counter pulsation (IABP) during PCI (26.3% versus 3.8%, p<0.001). After multiple logistic regression
analysis, prior history of CABG (OR = 6.1, 95% CI: 1.1-32.4, p = 0.03), baseline ejection fraction <30% (OR = 6.5, 95%
CI: 1.7-24.4, p = 0.005), and used of IABP during PCI (OR = 4.7, 95% CI: 1.3-16.8, p = 0.01) are the strongest predictors
of in-hospital MACE.
Conclusion : In the National Thai PCI Registry, patients with non-ST-T MI undergoing PCI had in-hospital major adverse
events rate at 5.6%. Prior CABG, low EF <30%, unstable hemodynamic required used of IABP during PCI and procedure
scheduled as an urgent or emergent were predictors of in-hospital MACE.
Keywords : Non-ST elevation myocardial infarction, In-hospital MACE, Thai National PCI Registry
