Outcomes of Percutaneous Coronary
Intervention in Patients with
Myelodysplastic Syndromes

Objectives
This study evaluates clinical outcomes of percutaneous coronary intervention
(PCI) in patients with myelodysplastic syndromes (MDS), a high-risk and
understudied population. It examines in-hospital mortality, bleeding
complications, and major adverse cardiovascular and cerebrovascular events
(MACCE) while exploring strategies to improve patient management. This is
the largest study to date on PCI outcomes in MDS patients.
Methods
This retrospective study analyzed the National Inpatient Sample (NIS)
database from 2016 to 2019. Adult patients (≥18 years) undergoing PCI were
divided into two groups: without MDS (n = 1,405,980) and with MDS (n =
1,640). Statistical analyses included chi-square tests, Student’s t-tests, and
multivariable logistic regression to evaluate the association of MDS with
clinical outcomes.
Results
The MDS group had higher in-hospital mortality (4.3% vs. 2.8%, p< 0.001)
and MACCE rates (8.5% vs. 6.5%, p<0.001). While acute ischemic CVA
incidence was slightly higher (1.2% vs. 1.0%), the difference was not
significant (p = 0.486). Surprisingly, bleeding complications, including major
bleeding (0.9% vs. 1.6%, p = 0.032) and intracranial hemorrhage (0.3% vs.
0.1%, p = 0.015), were less frequent in the MDS group. Multivariable analysis
showed MDS was independently associated with higher mortality (OR 1.059,
p < 0.0001) but lower odds of major bleeding (OR 0.341, p< 0.001).
Conclusion
Patients with MDS undergoing PCI have higher rates of in-hospital mortality
and major adverse cardiovascular and cerebrovascular events (MACCE)
compared to non-MDS patients. However, lower rates of major bleeding in
MDS patients, despite their bleeding predisposition, may reflect over-
monitoring bias and tailored management strategies. These findings highlight
the need for further research to better understand the complex interplay
between MDS-related factors and PCI outcomes.