Predictors of Major Adverse Cardiac Events After Percutaneous Coronary Intervention in Sana’a City-Yemen (Single center study)

Abstract

Background: Recently, many hospitals in Yemen have been started using Percutaneous Coronary Intervention (PCI) procedure for treatment coronary artery disease (CAD), including Dr. Hashim Eraqi hospital. However, there is no systematic research has so far been conducted to predict mortality and morbidity following PCI in Yemen. Aims: To estimate the incidence of PCI complications, and identify independent predictors of major adverse cardiac events (MACE) after PCI procedure. Patients and Methods: This is retrospective observational study included 202 patients who underwent PCI at Dr. Hashim Iraqi hospital, Sana’a City, Yemen from January 2020 till February 2021. Results: Median age was 58.5 (range = 28- 82) years. Out of our study subjects, 100 (49.5%) patients were ≥ 60 years. Majority were males 177 (87.6%). The most prevalent pre procedural risk factors were smoking in 136 (67.3%), sedentary life style in 129 (63.4%), hypertension (HTN) in 101 (50%) and ischemic heart disease (IHD) in 96 (47.5%) patients. In general, the incidence of PCI complications was nearly 28% observed in 56 patients. In hospital mortality occurred in only one patient (0.5%). Renal insufficiency and hypotension were the most common PCI complications observed in 28 (13.9%) and 19 (9.5%) patients respectively. MACE occurred in a total of 39 (19.3%) patients. We have found chronic kidney disease (CKD), pre-PCI left ventricular ejection fraction (LV EF) < 30%, developed cardiogenic shock, underwent multiple stents PCI, post PCI hemoglobin (Hb) < 11, and post PCI serum creatinine (S.Cr) > 2 to be significantly associated with increased MACE likely in hospital. Conclusion: The incidence of PCI complications was high in our study. CKD, pre-PCI LV EF < 30%, cardiogenic shock, post PCI Hb < 11, post PCI S.Cr > 2, and multiple stents PCI were independent predictors of MACE.