Skip to main content
Pulmonary artery catheterization in patients with acute coronary syndromes
GRACE Publications
  • Christopher P. Ruisi, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Brian M. Kennelly, Hoag Memorial Hospital Presbyterian
  • Shaun G. Goodman, University of Toronto
  • Jose Lopez-Sendon, Hospital Universitario Gregorio Maranon
  • Christopher B. Granger, Duke University
  • Alvaro Avezum, Dante Pazzanese Institute of Cardiology
  • Kim A. Eagle, University of Michigan
  • Gordon Fitzgerald, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
UMMS Affiliation
Center for Outcomes Research; Department of Medicine, Division of Cardiovascular Medicine
Document Type
Medical Subject Headings
Acute Coronary Syndrome; Adult; Aged; Catheterization, Swan-Ganz; Female; Hospital Mortality; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Registries
BACKGROUND: There are limited recent data evaluating the use of the pulmonary artery catheter (PAC) in patients hospitalized with an acute coronary syndrome (ACS). Using data from the multinational Global Registry of Acute Coronary Events, we examined trends in PAC use among patients hospitalized for an ACS and the association between PAC and hospital outcomes. METHODS: Trends in PAC utilization between 2000 and 2007 were examined through the review of data contained in hospital medical records. We identified factors associated with PAC utilization and compared differences in the length of hospitalization and in-hospital death rates between patients undergoing PAC during the index hospitalization (PAC+, n = 2,879) and those managed without PAC (PAC-, n = 56,091). RESULTS: The utilization of PAC during hospitalization for an ACS declined over time such that 3.0% of patients underwent PAC in 2007 compared with 5.4% in 2000. Admission Killip classification was the strongest factor associated with PAC insertion. The duration of hospitalization was significantly longer among PAC+ (median = 10.0 days) as compared with PAC- patients (median = 5.0 days). In-hospital death rates were significantly higher among PAC+ patients after adjustment for differences in baseline characteristics (odds ratio 4.00, 95% CI 3.41-4.70). CONCLUSIONS: The frequency of PAC utilization in "real-world" patients hospitalized with ACS has declined during recent years. Our finding of increased in-hospital mortality among patients undergoing PAC is consistent with prior studies and may further challenge the efficacy of PAC in the setting of ACS.
Rights and Permissions
Citation: Am Heart J. 2009 Aug;158(2):170-6. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Christopher P. Ruisi, Robert J. Goldberg, Brian M. Kennelly, Shaun G. Goodman, et al.. "Pulmonary artery catheterization in patients with acute coronary syndromes" Vol. 158 Iss. 2 (2009) ISSN: 0002-8703 (Linking)
Available at: