Acute myocardial ischaemia and cardiogenic shock after percutaneous transluminal coronary angioplasty; risk factors for and results of emergency coronary bypass

Between 1 September, 1980 and 1 January, 1989, 4142 patients underwent percutaneous transluminal coronary angioplasty (PTCA). We retrospectively studied the 155 [3·7%; 119 males, mean age 53·4 years, (range 33–78 years) and 36 females, mean age 59·6 years (range 40–74 years) ] who required urgent coronary artery bypass grafting (CABG) (Group I) and a select control group of 155 patients, in whom PTCA was performed without complications (Group II). Before PTCA, 14 Group I and 42 Group II patients had angina Class II, and 78 Group I and 49 Group II patients had angina class IV (X2-test, P < 0·05). There were 445 complications in the 155 group I patients: 303 (68%) early (during PTCA) and 141 (32%) late (within24 h). Onarrivalin the operating room 126 patients were stable;five were in cardiac arrest and 19 in cardiogenic shock (AS-group; 24 patients). In the AS-group and control group, respectively, angina Class II occurred in 2/24 (8·3%) and 42/155 (27·1%) patients, angina Class IV in 14/24 (58·3%) and49/155 (31·6%) (P