Original Research

Evaluating Clinical Outcomes and Complications of Left Heart Catheterization as a Therapeutic Procedure in Acute Coronary Syndrome

Muhammad Salman Daood1
Alhada Military Hospital, Kingdom of Saudi Arabia
Muhammad Ahmad Raza Butt2
Hameed Latif Hospital, Lahore, Pakistan
Sidra Anwar3
Fatima Memorial Hospital, Lahore, Pakistan
Muhammad Kamran Rauf3
Fatima Memorial Hospital, Lahore, Pakistan
Mansoor Ghani4
University of Health Sciences, Lahore, Pakistan
Saliha Mushtaq5
Rehmatul-Lil- Alameen Institute of Cardiology PESSI Lahore, Pakistan

✉ Correspondence: Muhammad Salman Daood Email: muhammadsalmandaood43701@import.invalid

DOI https://doi.org/10.70302/jpsim.v6i3.2551
Volume: 6, Issue 3 Pages: 273–278 Published: 23 Aug 2025
Received: 06 Sep 2024 Revised: 10 Jan 2025 Accepted: 24 Jul 2025 Published Online: 23 Aug 2025

Abstract

Objective

This study aimed to assess the prevalence and types of complications related to cardiac catheterization in patients with acute coronary syndrome (ACS), identify the most common adverse events such as bleeding, infections, pulmonary edema, contrast-induced nephropathy, arrhythmias, and stroke, and provide recommendations for their prevention, early detection, and management.

Methods

A prospective study was conducted at Hameed Latif Hospital, Lahore, involving 220 patients diagnosed with ACS who underwent cardiac catheterization. Participants aged 18–75 years were selected through simple random sampling. Patients with prior CABG, bleeding disorders, advanced renal disease, pregnancy, or psychiatric illness were excluded. Data were collected on common post-catheterization complications, including vascular bleeding, infections, arrhythmias, contrast-induced nephropathy, stroke, and death. Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants. Data were analyzed using SPSS version 26, with results expressed as means, standard deviations, frequencies, and percentages, applying a significance level of 0.05.

Results

The patients had a mean age of 59.42 ± 9.36 years, with a slight male predominance (55.3%). Key complications identified included access site bleeding (0.9%), hematoma formation (2.6%), pulmonary edema (0.9%), cardiac arrhythmias (0.9%), cerebrovascular accidents (0.4%), acute stent thrombosis (0.4%), and death (0.4%). Radial access was used in 82.9% of procedures. No cases of contrast-induced nephropathy were reported.

Conclusion

The detailed focus on coronary angiography provided valuable insights into specific outcomes and significant complications. This research underscores the importance of specialized techniques and risk management in cardiac catheterization to better overall patient outcomes.

Keywords
Cardiac catheterization Acute coronary syndrome Therapeutic Complications

How to Cite This Article

Daood MS, Butt MAR, Anwar S, Rauf MK, Ghani M, Mushtaq S. Evaluating Clinical Outcomes and Complications of Left Heart Catheterization as a Therapeutic Procedure in Acute Coronary Syndrome. J Pak Soc Intern Med. 2025;6(3):273–278. doi:10.70302/jpsim.v6i3.2551

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

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  10. Noto TJ Jr, Johnson LW, Krone R, Weaver WF, Clark DA, Kramer JR Jr et al. Cardiac catheterization 1990: a report of the registry of the Society for Cardiac Angiography and Interventions (SCA&I). Cathet Cardiovasc Diagn. 1991;24(2):75–83.
  11. Johnson LW, Lozner EC, Johnson S, Krone R, Pichard AD, Vetrovec GW, et al. Coronary arteriography 1984-1987: a report of the Registry of the Society for Cardiac Angiography and Interventions. I. Results and complications. Cathet Cardiovasc Diagn. 1989;17(1):5-10.
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  14. Ram P, Horn B, Lo KBU, Pressman G, Rangaswami J. Acute Kidney Injury Post Cardiac Catheterization: Does Vascular Access Route Matter? Curr Cardiol Rev. 2019;15(2):96-101.
  15. Alkagiet S, Petroglou D, Nikas DN, Kolettis TM. Access-site Complications of the Transradial Approach: Rare But Still There. Curr Cardiol Rev. 2021;17(3):279-93.
  16. Ullrich H, Münzel T, Gori T. Coronary Stent Thrombosis- Predictors and Prevention. Dtsch Arztebl Int. 2020;117(18):320-26.
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  18. Shaik FA, Slotwiner DJ, Gustafson GM, Dai X. Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature. World J Cardiol. 2020; 12(6):269-84.
  19. Doyle BJ, Rihal CS, Gastineau DA, Holmes DR Jr. Bleeding, blood transfusion, and increased mortality after percutaneous coronary intervention: implications for contemporary practice. J Am Coll Cardiol. 2009;53(22):2019-27.
  20. Marin AC, Prasad A, Machchhar RR, Patel V, Shah V, Ghodasara K, et al. A Case Report of Sepsis Post Cardiac Catheterization . Cureus. 2022 Dec 26; 14(12):e32977. doi: 10.7759/cureus.32977. PMID: 36712763; PMCID: PMC9879584. doi:10.7759/cureus.32977
  21. Sudarsky D, Nikolsky E. Contrast-induced nephropathy in interventional cardiology. Int J NephrolRenovasc Dis. 2011;4:85-99.
  22. Cortese B, Sciahbasi A, Sebik R, Rigattieri S, Alonzo A, Silva-Orrego P, et al. Comparison of risk of acute kidney injury after primary percutaneous coronary interventions with the transradial approach versus the transfemoral approach (from the PRIPITENA urban registry). Am J Cardiol. 2014;114(6):820-5.
  23. Dukkipati S, O'Neill WW, Harjai KJ, Sanders WP, Deo D, Boura JA, etal. Characteristics of cerebrovascular accidents after percutaneous coronary interventions, J Am Coll Cardiol.2004;43(7):1161-7.
  24. Chiarito, M, Cao, D, Nicolas, J, Roumeliotis A, Power D, Chandiramani R, et al. Radial versus femoral access for coronary interventions: An updated systematic review and meta-analysis of randomized trials. Catheter CardiovascInterv. 2021; 97: 1387-96.
  25. Cram P, House JA, Messenger JC, Piana RN, Horwitz PA, Spertus JA. Percutaneous coronary intervention outcomes in US hospitals with varying structural characteristics: analysis of the NCDR®. Am Heart J. 2012;163(2):222-9.e1.
  26. Mohammed A. Al-Hijji, Ryan J. Lennon, Rajiv Gulati, Abdallah El Sabbagh, et al. Safety and Risk of Major Complications With Diagnostic Cardiac Catheterization. Cardiov Interv. 2019;12:e007791)
  27. Noto TJ Jr, Johnson LW, Krone R, Weaver WF, Clark DA, Kramer JR Jr et al. Cardiac catheterization 1990: a report of the registry of the Society for Cardiac Angiography and Interventions (SCA&I). Cathet Cardiovasc Diagn. 1991;24(2):75–83.
  28. Johnson LW, Lozner EC, Johnson S, Krone R, Pichard AD, Vetrovec GW, et al. Coronary arteriography 1984-1987: a report of the Registry of the Society for Cardiac Angiography and Interventions. I. Results and complications. Cathet Cardiovasc Diagn. 1989;17(1):5-10.
  29. Johnson LW, Krone R. Cardiac catheterization 1991: a report of the registry of the Society for Cardiac Angiography and Interventions (SCA&I).Cathet Cardiovasc Diagn. 1993;28(2):219–20.
  30. Kolte D, Spence N, Puthawala M, Hyder O, Tuohy CP, Davidson CB, et al. Association of radial versus femoral access with contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction. Cardiovasc Revasc Med. 2015;17(8): 546-51.
  31. Ram P, Horn B, Lo KBU, Pressman G, Rangaswami J. Acute Kidney Injury Post Cardiac Catheterization: Does Vascular Access Route Matter? Curr Cardiol Rev. 2019;15(2):96-101.
  32. Alkagiet S, Petroglou D, Nikas DN, Kolettis TM. Access-site Complications of the Transradial Approach: Rare But Still There. Curr Cardiol Rev. 2021;17(3):279-93.
  33. Ullrich H, Münzel T, Gori T. Coronary Stent Thrombosis- Predictors and Prevention. Dtsch Arztebl Int. 2020;117(18):320-26.
  34. Martín-Aguilar L, Paré-Curell M, Dorado L, Pérez de la Ossa-Herrero N, Ramos-Pachón A, López-Cancio E, et al. Ischaemic stroke as a complication of cardiac catheterisation. Clinical and radiological characteristics, progression, and therapeutic implications. Neurologia (Engl Ed). 2022;37(3):184-91.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.
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