Coronary arteriography carries a very low overall mortality rate (0.098%), though risk is significantly elevated in patients with advanced age, severe heart failure symptoms, left main disease, or severely reduced ejection fraction.
Identifies high-risk features warranting caution during coronary arteriography; leaves open whether risk mitigation alters outcomes.
In a 42-month period, 218 deaths occurred in 222,553 patients undergoing coronary arteriography (0.098%). Age greater than 60 years, NYHA Class IV function, presence of left main coronary disease, and ejection fraction less than 30% all significantly increased the risk of the procedure. Sex and approach (brachial or femoral) used for the catheterization did not affect mortality. Since the SCAI report in 1982, the death rate has dropped significantly in high-risk patients. Low-risk patients (NYHA Class I or normal coronary arteries) who died generally were elderly or had associated valvular heart disease.
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Lozner et al. (1989) studied this question.
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