Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Catheter Cardiovasc Interv. 2024 Oct;104(4):707-713. doi: 10.1002/ccd.31213. Epub 2024 Sep 9.
Cardiac tamponade or pericardial tamponade (PT) can be a complication following invasive cardiac procedures.
Patients who underwent various procedures in the cardiac catheterization lab (viz. coronary interventions) were identified using the International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification (International classification of diseases [ICD]-9-Clinical modification [CM] and ICD-10-CM, respectively) from the Nationwide Inpatient Sample (NIS) database. Patient demographics, presence of comorbidities, PT-related events, and in-hospital death were also abstracted from the NIS database.
The frequency of PT-related events in the patients undergoing CI from 2010 to 2017 ranged from 3.3% to 8.4%. Combined in-hospital mortality/morbidity of PT-related events were higher with increasing age (odds ratio [OR] [95% CI]: chronic total occlusion (CTO) = 1.19 [1.10-1.29]; acute coronary syndrome (ACS) = 1.21 [1.11-1.33], both p < 0.0001) and female sex (OR [95%CI]: CTO = 1.70 [1.45-2.00]; ACS = 1.72 [1.44-2.06], both p < 0.0001). In-hospital mortality related to PT-related events was found to be 8.5% for coronary procedures. In-hospital mortality was highest amongst the patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for ACS (ACS vs. non-CTO PTCA vs. CTO PTCA: 15.7% vs. 10.4% and 14.4%, p < 0.0001 and ACS vs. non-CTO PTCA vs. CTO PTCA: 12.1% vs. 8.1% and 5.6%, p = 0.0001, respectively).
In the real-world setting, PT-related events in CI were found to be 3.3%-8.4%, with in-hospital mortality of 8.5%. The patients undergoing PTCA for ACS were found to have highest mortality. Older patients undergoing CTO PTCA independently predicted higher mortality.
心脏压塞或心包压塞（PT）可能是侵入性心脏手术的并发症。
使用国际疾病分类，第九和第十版，临床修正版（国际疾病分类[ICD]-9-临床修正版[CM]和 ICD-10-CM）从全国住院患者样本（NIS）数据库中确定在心脏导管室进行各种程序（即冠状动脉介入治疗）的患者。还从 NIS 数据库中提取患者人口统计学资料、合并症、PT 相关事件和院内死亡情况。
2010 年至 2017 年，接受 CI 的患者中 PT 相关事件的频率范围为 3.3%至 8.4%。PT 相关事件的综合院内死亡率/发病率随年龄增加而升高（优势比[OR] [95%CI]：慢性完全闭塞[CTO] = 1.19 [1.10-1.29]；急性冠状动脉综合征[ACS] = 1.21 [1.11-1.33]，均 p < 0.0001）和女性性别（OR [95%CI]：CTO = 1.70 [1.45-2.00]；ACS = 1.72 [1.44-2.06]，均 p < 0.0001）。发现与 PT 相关事件相关的院内死亡率为冠状动脉手术的 8.5%。接受经皮冠状动脉腔内成形术（PTCA）治疗 ACS 的患者的院内死亡率最高（ACS 与非 CTO PTCA 与 CTO PTCA：15.7%与 10.4%和 14.4%，p < 0.0001 和 ACS 与非 CTO PTCA 与 CTO PTCA：12.1%与 8.1%和 5.6%，p = 0.0001）。
在真实环境中，CI 中与 PT 相关的事件发生率为 3.3%-8.4%，院内死亡率为 8.5%。接受 ACS 行 PTCA 的患者死亡率最高。接受 CTO PTCA 的老年患者独立预测死亡率更高。
