Erratum to Correct Informed Patient Consent Statement.

[This corrects the article DOI: 10.17925/EE.2023.19.2.6.].

Prevalence and Impact of Concomitant Atrial Fibrillation in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction.

Background: Concomitant atrial fibrillation (AF) is associated with an adverse prognosis in patients with acute myocardial infarction (MI). However, it remains unclear whether this is due to a causal effect of AF or whether AF acts as a surrogate marker for comorbidities in this population. Furthermore, there are limited data on whether coronary artery disease distribution impacts the risk of developing AF. Methods: Consecutive patients admitted with acute MI and treated using percutaneous coronary intervention (PCI) at a single centre were retrospectively identified. Associations between AF and major adverse cardiac and cerebrovascular events (MACCEs) over a median of five years of follow-up were assessed using Cox regression, with adjustment for confounding factors performed using both multivariable modelling and a propensity-score-matched analysis. Results: AF was identified in N = 65/1000 (6.5%) of cases; these patients were significantly older (mean: 73 vs. 65 years, p < 0.001), with lower creatinine clearance (p < 0.001), and were more likely to have a history of cerebrovascular disease (p = 0.011) than those without AF. In addition, patients with AF had a greater propensity for left main stem (p = 0.001) or left circumflex artery (p = 0.004) involvement. Long-term MACCE rates were significantly higher in the AF group than in the non-AF group (50.8% vs. 34.2% at five years), yielding an unadjusted hazard ratio (HR) of 1.86 (95% CI: 1.32-2.64, p < 0.001). However, after adjustment for confounding factors, AF was no longer independently associated with MACCEs, either on multivariable (adjusted HR: 1.25, 95% CI: 0.81-1.92, p = 0.319) or propensity-score-matched (HR: 1.04, 95% CI: 0.59-1.82, p = 0.886) analyses. Conclusions: AF is observed in 6.5% of patients admitted with acute MI, and those with AF are more likely to have significant diseases involving left main or circumflex arteries. Although unadjusted MACCE rates were significantly higher in patients with AF, this effect was not found to remain significant after adjustment for comorbidities. As such, this study provided no evidence to suggest that AF is independently associated with MACCEs.

Chromene-chromene Schiff base as a fluorescent chemosensor for Th4+ and its application in bioimaging of Caenorhabditis elegans.

The manuscript presents the synthesis of a new di-chromene Schiff base (COM-CH) by combining 7-(diethylamino)-2-oxo-2H-chromene-3-carbohydrazide and 4-oxo-4H-chromene-3-carbaldehyde, and its characterization using various analytical techniques. The probe COM-CH functional group contains a hard donor atom that selectively complexes with Th4+ ions. This report investigated COM-CH's sensing ability towards Th4+ chromogenic and fluorogenic methods in ACN: H2O (8:2, v/v) with Th4+ ions. The COM-CH-Th4+ complex was excited at 430 nm, resulting in a bright emission band at 475 nm with a 45 nm Stokes shift. The COM-CH probe demonstrated the highest performance at pH 4.0 to 8.0, with a sensitivity of 18.7 nM. The complex formation of COM-CH with Th4+ was investigated using NMR, FTIR spectrometry, and density functional theory calculations. The COM-CH and Th4+ are bound with 2:1 stoichiometry and an association constant of 1.92 × 108 M-2. The probe's performance enabled the analysis of monazite sand and water samples for Th4+ content. The probe successfully detected Th4+ content in Caenorhabditis elegans, marking the first Th4+ detection in animal models.

Parathyroid Carcinoma Presenting as Recurrent Primary Hyperparathyroidism and Neck Mass: A Case Report.

Parathyroid carcinoma is a rare endocrine neoplasm that accounts for <1% of cases of primary hyperparathyroidism. The management of parathyroid carcinoma is a challenge due to the high rate of local recurrence of the tumour. We report the case of a middle-aged north Indian woman who presented with recurrent primary hyperparathyroidism due to parathyroid carcinoma. She presented with a recurrent palpable hard neck mass and underwent radical dissection of the neck six times. At the time of writing this report, she was referred for external beam radiotherapy to the neck. Parathyroid carcinoma is a rare malignancy with an indolent but tenacious course. Complete resection at the time of initial surgery determines the prognosis of the neoplasm. Chemotherapy and radiotherapy are usually ineffective. Hypercalcaemia needs to be aggressively managed. A multidisciplinary team is required to effectively manage parathyroid carcinoma.

Intra-coronary physiology in contemporary percutaneous coronary intervention and anginal therapy with a focus on microvascular disease.

Coronary physiological measurements have transformed the treatment of coronary artery disease (CAD), with increasing evidence supporting the use of pressure wire guided revascularisation. Advances in microvascular assessment have enabled clinicians to discern angina aetiology even in patients without obstructive epicardial coronary artery disease, paving the way for more effective tailored therapy. In this article, the authors will examine pressure wire indices, their role in influencing clinical outcomes and future directions.

A Novel Potential Treatment for Diabetic Foot Ulcers and Non-Healing Ulcers - Case Series.

INTRODUCTION: Appropriate care and treatment of a wound is the need of the hour whether it is an infected or a non-infected wound. If wound healing is delayed for some reason, it leads to serious complications and further increases the hospital stay and cost of treatment. Herein, we describe a novel antimicrobial wound dressing formulation (VG111), with an objective to generate the preliminary data showing the distinct advantages in various types of wounds. METHOD: This case series involved the treatment of acute cases of wounds or chronic wounds that did not respond well to conventional wound healing treatments with VG111 in patients with different etiologies. Thirteen cases of patients that included patients with diabetes, pressure ulcers, burns, trauma, and others treated with VG111 showed rapid wound healing in all the cases, even obviating the need for a graft when complete skin regeneration occurred RESULT: This was illustrated by clearing of the wound infections, reduction/disappearance of the exudate, appearance of intense granulation, epithelialization, and anti-biofilm activity followed by complete wound closure. This VG111 precludes the need for systemic antimicrobial agents in localized infections and therefore, this single agent is an attempt to address the limitations and the drawbacks of the available products. CONCLUSION: Despite patients belonging to the old age group and having comorbidities like diabetes, still VG111 showed effective rapid wound healing, and that too without any scar formation in hardto-heal, infected, and non-infected wounds

Recent advances in biomacromolecule-based nanocomposite films for intelligent food packaging- A review.

In food packaging, biopolymer films are biodegradable films made from biomacromolecule-based natural materials, while biocomposite films are hybrids of two or more materials, with at least one being biodegradable. Bionanocomposites are different than the earlier ones, as they consist of various nanofillers (both natural and inorganic) in combination with biomacromolecule-based biodegradable materials to make good compostable bionanocomposites. In this regard, a new type of material known as bionanocomposite has been recently introduced to improve the properties and performance of biocomposite films. Bionanocomposites are primarily developed for active packaging, but their use in intelligent packaging is also noteworthy. For example, bionanocomposites developed using a hybrid of anthocyanin and carbon dots as intelligent materials have shown their high pH-sensing properties. The natural nanofillers (like nanocellulose, nanochitosan, nanoliposome, cellulose nanocrystals, cellulose nanofibers, etc.) are being employed to promote the sustainability, degradability and safety of bionanocomposites. Overall, this article comprehensively reviews the latest innovations in bionanocomposite films for intelligent food packaging over the past five years. In addition to packaging aspects, the role of nanofillers, the importance of life cycle assessment (LCA) and risk assessment, associated challenges, and future perspectives of bionanocomposite intelligent films are also discussed.

Extractive Spectrophotometric Detection of Sn(II) Using 6-bromo-3-hydroxy-2-(5-methylfuran-2-yl)-4H-chromen-4-one.

For the determination of tin(II) traces, an extractive spectrophotometric approach is devised. The applied method serves a powerful tool for determination of tin(II), involves the formation of yellow colored complex after the binding of 6-bromo-3-hydroxy-2-(5-methylfuran-2-yl)-4H-chromen-4-one (BHMF) and tin(II) in 1:2 stiochiometry in a slightly acidic medium (HCl). The complex shows absorbance at 434 nm with respect of the blank reagent. The outcomes of spectral investigation for complexation showed a Beer's range of 0-1.3 µg Sn mL-1, molar absorptivity, specific absorptivity and Sandell's complex sensitivity are 9.291 × 104 L mol-1 cm-1, 0.490 mL g-1 cm-1 and 0.002040 µg cm-2 at 434 nm that was stable for two days. The interferences study results showed that this method is free from interferences, when tested with metal ions including Ag, Be, Bi, Ca, Cd, Ce, Co, Hg, Mo, Re, Pt, Se,Ti, U, V, W and other common cations, anions, and complexing agents. The applied method is quite simple, highly selective, and sensitive with good re-producibility. This method has been satisfactorily by utilizing the proposed procedure, and its applicability has been tested by analyzing synthetic samples and an alloy sample of gunmetal. The procedure assumes this because of the scarcity of better methods for determining tin(II). The results are in good agreement with the certified value.

Antithrombotic therapy following transcatheter aortic valve intervention.

Transcatheter aortic valve replacement (TAVR) is increasingly being performed to treat symptomatic patients with aortic stenosis and annual procedure volume has overtaken surgical aortic valve replacement in the United States. However, current international guidelines were written prior to the publication of several important recent studies. Furthermore, European and American guidelines differ in their recommendations of antithrombotic therapy following TAVR. Consequently, there is a need to examine the literature to provide clinicians guidance on the optimum antithrombotic strategy, particularly as different patient populations exist. In this review, we examine the data for antiplatelet and anticoagulation therapy post-TAVR.

Management of secondary mitral regurgitation: from drugs to devices.

Severe secondary mitral regurgitation carries a poor prognosis with one in five patients dying within 12 months of diagnosis. Fortunately, there are now a number of safe and effective therapies available to improve outcomes. Here, we summarise the most up-to-date treatments. Optimal guideline-directed medical therapy is the mainstay therapy and has been shown to reduce the severity of mitral regurgitation in 40-45% of patients. Rapid medication titration protocols reduce heart failure hospitalisation and facilitate earlier referral for device therapy. The pursuit of sinus rhythm in patients with atrial fibrillation has been shown to significantly reduce mitral regurgitation severity, as has the use of cardiac resynchronisation devices in patients who meet guideline-directed criteria. Finally, we highlight the key role of mitral valve intervention, particularly transcatheter edge-to-edge repair (TEER) for management of moderate-severe mitral regurgitation in carefully selected patients with poor left ventricular systolic function, with a number needed to treat of 3.1 to reduce heart failure hospitalisation and 5.9 to reduce all-cause death. To slow the rapid accumulation of morbidity and mortality, we advocate a proactive approach with accelerated medical optimisation, followed by management of atrial fibrillation and cardiac resynchronisation therapy if indicated, then, rapid referral to the Heart Team for consideration of mitral valve intervention in patients with ongoing symptoms and at least moderate-severe mitral regurgitation. Mitral TEER has been shown to be 'reasonably cost-effective' (but not cost-saving) in the UK in selected patients, although TEER remains underused with only 6.5 procedures per million population (pmp) compared with Germany (77 pmp), Switzerland (44 pmp) and the USA (32 pmp).

Predictors and clinical implications of residual mitral regurgitation following left ventricular assist device therapy.

BACKGROUND: Correction of mitral regurgitation (MR) at the time of left ventricular assist device (LVAD) implantation remains controversial. There is conflicting evidence regarding the clinical impact of residual MR, and studies have not examined whether MR aetiology or right heart function impacts the likelihood of residual MR. METHODS: This is a retrospective single-centre study of 155 consecutive patients with LVAD implantation from January 2011 to March 2020. Exclusion criteria were no MR pre-LVAD (n=8), inaccessible echocardiography (n=9), duplicate records (n=10) and concomitant mitral valve repair (n=1). Statistical analysis was performed using STATA V.16 and SPSS V.24. RESULTS: Carpentier IIIb MR aetiology was associated with more severe MR pre-LVAD (severe 18/27 (67%) vs non-severe 32/91 (35%), p=0.004) and a higher likelihood of residual MR (8/11 (72%) vs 30/74 (41%), p=0.045). Of 95 patients with significant MR pre-LVAD, 15 (16%) had persistent significant MR, which was associated with higher mortality (p=0.006), post-LVAD right ventricle (RV) dilatation (10/15 (67%) vs 28/80 (35%), p=0.022) and RV dysfunction (14/15 (93%) vs 35/80 (44%), p<0.001). Aside from ischaemic aetiology, other pre-LVAD parameters that were associated with significant residual MR included left ventricular end-systolic diameter (LVESD) (6.9 cm (5.7-7.2) vs 5.9 cm (5.5-6.5), p=0.043), left atrial volume index (LAVi) (78 mL/m2 (56-88) vs 57 mL/m2 (47-77), p=0.021), posterior leaflet displacement (2.5 cm (2.3-2.9) vs 2.3 cm (1.9-2.7), p=0.042) and basal right ventricular end-diastolic diameter (RVEDD) (5.1±0.8 cm vs 4.5±0.8 cm, p=0.010). CONCLUSION: LVAD therapy improves MR and tricuspid regurgitation severity in the majority, but 14% have persistent significant residual MR, associated with right ventricular dysfunction and higher long-term mortality. This may be predicted pre-LVAD by greater LVESD, RVEDD and LAVi and by ischaemic aetiology.

Investigating the Effect of Supercritical Carbon Dioxide Treatment on the Rheological, Thermal, and Functional Properties of Plum (Prunus domestica L.) Kernel Protein Isolates.

Plum kernels are a promising source of dietary proteins that are irretrievably lost during processing. The recovery of these underexploited proteins could be eminently vital for human nutrition. Plum kernel protein isolate (PKPI) was prepared and exposed to a targeted supercritical carbon dioxide (SC-CO2) treatment to diversify its effectiveness in industrial applications. The impacts of SC-CO2 treatment at different processing temperatures (30-70 °C) on dynamic rheology, microstructure, thermal, and techno-functional characteristics of PKPI were investigated. The results revealed that the dynamic viscoelastic characteristics of SC-CO2-treated PKPIs showed higher storage modulus, loss modulus, and lower tan δ value than native PKPI, indicating greater strength and elasticity of the gels. Microstructural analysis showed that the proteins experienced denaturation at elevated temperatures and resulted in the formation of soluble aggregates, which increased the heat requirement for thermal denaturation of SC-CO2-treated samples. SC-CO2-treated PKPIs demonstrated a decline of 20.74% and 30.5% in crystallite size and crystallinity. PKPIs treated at 60 °C showed the highest dispersibility, which was 1.15-fold higher than the native PKPI sample. SC-CO2 treatment offers a novel path to improve the techno-functional properties of PKPIs and extend its use in food and non-food applications.

Structural modification of plum (Prunus domestica L) kernel protein isolate by supercritical carbon-dioxide treatment: Functional properties and in-vitro protein digestibility.

The effect of supercritical carbon dioxide (SC-CO2) treatment at different processing temperatures (30-70 °C) on the physico-functional properties, structural features, and in-vitro digestibility (IVPD) of plum kernel protein isolates (PKPI) was examined. The results revealed remarkable changes in the secondary structures of SC-CO2-treated PKPIs, including a decrease in α-helix proportion, a concomitant increase in ß-sheet content, and a considerable variation in random coils and ß-turn structures. The temperature rise increased the negative zeta potential to a maximum of 31.35 mV at 60 °C, exhibiting the colloidal stability of PKPI dispersions. SDS-PAGE analysis showed variations in the intensities of protein bands, indicating denaturation and aggregation at higher temperatures. These structural and molecular changes improved water-binding capacity (1.22-fold) and oil binding capacity (1.11-fold), wettability (1.12-fold), and the highest value in all the properties was recorded at 60 °C. Moreover, the highest IVPD value (21.58 %) and a distinguishable colour difference (∆E) of 8.11 was also obtained at 60 °C of the processing temperature. Therefore, SC-CO2 treatment-induced modification of PKPI contributed to the enhanced digestibility and techno-functional properties, which offered new prospects to extend its use in food applications.

Memetic Spider Monkey Optimization for Spam Review Detection Problem.

Spider monkey optimization (SMO) algorithm imitates the spider monkey's fission-fusion social behavior. It is evident through literature that the SMO is a competitive swarm-based algorithm that is used to solve difficult real-life problems. The SMO's search process is a little bit biased by the random component that drives it with high explorative searching steps. A hybridized SMO with a memetic search to improve the local search ability of SMO is proposed here. The newly developed strategy is titled Memetic SMO (MeSMO). Further, the proposed MeSMO-based clustering approach is applied to solve a big data problem, namely, the spam review detection problem. A customer usually makes decisions to purchase something or make an image of someone based on online reviews. Therefore, there is a good chance that the individuals or companies may write spam reviews to upgrade or degrade the stature or value of a trader/product/company. Therefore, an efficient spam detection algorithm, MeSMO, is proposed and tested over four complex spam datasets. The reported results of MeSMO are compared with the outcomes obtained from the six state-of-art strategies. A comparative analysis of the results proved that MeSMO is a good technique to solve the spam review detection problem and improved precision by 3.68%.

Siamese-Based Architecture for Cross-Lingual Plagiarism Detection in English-Hindi Language Pairs.

The cross-lingual plagiarism detection (CLPD) is a challenging problem in natural language processing. Cross-lingual plagiarism is when a text is translated from any other language and used as it is without proper acknowledgment. Most of the existing methods provide good results for monolingual plagiarism detection, whereas the performances of existing methods for the CLPD are very limited. The reason for this is that it is difficult to represent the text from two different languages in a common semantic space. In this article, a novel Siamese architecture-based model is proposed to detect the cross-lingual plagiarism in English-Hindi language pairs. The proposed model combines the convolutional neural network (CNN) and bidirectional long short-term memory (Bi-LSTM) network to learn the semantic similarity among the cross-lingual sentences for the English-Hindi language pairs. In the proposed model, the CNN model learns the local context of words, whereas the Bi-LSTM model learns the global context of sentences in forward and backward directions. The performances of the proposed models are evaluated on the benchmark data set, that is, Microsoft paraphrase corpus, which is converted in the English-Hindi language pairs. The proposed model outperforms other models giving 67%, 72%, and 67% weighted average precision, recall, and F1-measure scores. The experimental results show the effectiveness of the proposed models over the baseline models because the proposed model is very efficient in representing the cross-lingual text very efficiently.

Left ventricular T1-mapping in diastole versus systole in patients with mitral regurgitation.

Cardiovascular magnetic resonance T1-mapping enables myocardial tissue characterisation, and is capable of quantifying both intracellular and extracellular volume. T1-mapping is conventionally performed in diastole, however, we hypothesised that systolic readout would reduce variability due to a reduction in myocardial blood volume. This study investigated whether T1-mapping in systole alters T1 values compared to diastole and whether reproducibility alters in atrial fibrillation compared to sinus rhythm. We prospectively identified 103 consecutive patients recruited to the Mitral FINDER study who had T1 mapping in systole and diastole. These patients had moderate or severe mitral regurgitation and a high incidence of ventricular dilatation and atrial fibrillation. T1, ECV and goodness-of-fit (R2) values of the T1 times were calculated offline using Circle cvi42 and in house-developed software. Systolic T1 mapping was associated with fewer myocardial segments being affected by artefact compared to diastolic T1 mapping [217/2472 (9%) vs 515/2472 (21%)]. Mean native T1 values were not significantly different when measured in systole and diastole (985 ± 26 ms vs 988 ± 29 respectively; p = 0.061) and mean post-contrast values showed similar good agreement (462 ± 32 ms vs 459 ± 33 respectively, p = 0.052). No clinically significant differences in ECV, native T1 and post-contrast T1 were identified between diastolic and systolic T1 maps in males versus females, or in patients with permanent atrial fibrillation versus sinus rhythm. A statistically significant improvement in R2 value was observed with systolic over diastolic T1 mapping in all analysed maps (n = 411) (96.2 ± 1.4% vs 96.0 ± 1.4%; p < 0.001) and in subgroup analyses [Sinus rhythm: 96.1 ± 1.4 vs 96.3 ± 1.4 (n = 327); p < 0.001. AF: 95.5 ± 1.3 vs 95.9 ± 1.2 (n = 80); p < 0.001] [Males: 95.8 ± 1.4 vs 96.1 ± 1.3 (n = 264); p < 0.001; Females: 96.2 ± 1.3 vs 96.4 ± 1.4 (n = 143); p = 0.009]. In conclusion, myocardial T1 mapping is associated with similar T1 and ECV values in systole and diastole. Furthermore, systolic acquisition is less prone to gating artefact in arrhythmia.

Evaluation of ultrasonication and carbonation-ultrasonication assisted convective drying techniques for enhancing the drying rates and quality parameters of ripe and raw banana (Musa) peel.

Raw and ripe banana (Musa Cavendish) peel slices were dried by application of ultrasonication (U) and carbonation-ultrasonication (CU) as pre-treatments for tray drying (T) at 60 °C. Lesser drying time and higher diffusivity was noticed in CU + T dried samples followed by U + T and T dried samples. Model 'Wang and Singh' was identified as the excellently fitting model to experimental data. SEM images of dried samples revealed the microchannels formation due to U treatment, which were more couloir after CU treatment. Water and oil holding capacity (WHC and OHC) for raw peel powders was higher than ripened peel powders at 40, 60 and 80 °C. WHC and OHC increased significantly after U + T drying or CU + T drying as compared to T drying for ripe and raw peel powder samples. Back extrusion force (BEF) varied from 67.42 to 69.22 N and from 84.6 to 86.02 N for ripe and raw peel samples respectively. Given treatments resulted in lesser colour change and Browning Index. But U + T or CU + T treatment did not affect BEF significantly. CU + T was deemed to be the appropriate drying technique for ripe and raw banana peel drying. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-022-05535-9.

Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI.

BACKGROUND: Small studies have suggested left ventricular (LV) rapid pacing has similar safety and efficacy to conventional right ventricular (RV) rapid pacing in transcatheter aortic valve implantation (TAVI). However, there are limited data on the comparative rates of tamponade. The study compared the rate of cardiac tamponade between LV and RV-pacing during TAVI. METHODS: Between 2008 and 2021, 1226 consecutive patients undergoing transfemoral or transaxillary TAVI were included. 470(38.3%) patients had TAVI deployment with RV-pacing and 756(61.7%) with LV-pacing. The primary outcome was the frequency and cause of cardiac tamponade. Secondary outcomes included efficacy, procedure duration and crossover rates. RESULTS: There was a trend to less tamponade with LV-pacing, which did not reach statistical significance [11(2.3%) vs 11(1.5%);P = 0.27]. There was no significant difference in the frequency of tamponade due to annular tear [4(0.9%) vs 9(1.2%);P = 0.59] or LV free-wall perforation [1(0.2%) vs 2(0.3%);P = 0.86]. The frequency of tamponade due to RV perforation was significantly lower in the LV-pacing group [0 vs 6(2.3%);P < 0.005)]. Two patients with tamponade due to RV perforation required emergency sternotomy of whom one died. Deployment success was similar (99% vs 99.6%;P=NS). Procedure duration was shorter with LV-pacing (70 vs 80 mins;P < 0.005). Crossover to RV-pacing was low (0.9%). There were no embolizations caused by loss-of-capture in either group. CONCLUSIONS: LV-pacing appears equally efficacious and is associated with a lower risk of tamponade due to RV perforation caused by the temporary pacing wire. LV-pacing was not associated with an increased risk of tamponade due to LV free-wall perforation.

Changing trends in the incidence, management and outcomes of coronary artery perforation over an 11-year period: single-centre experience.

INTRODUCTION: Coronary artery perforation (CP) is a rare but life-threatening complication of percutaneous coronary intervention (PCI). This study aimed to assess the incidence, management and outcomes of CP over time. METHODS: A single-centre retrospective cohort study of all PCIs performed between January 2010 and December 2020. Patients with CP were divided into two cohorts (A+B), representing the two halves of the 11-year study. RESULTS: The incidence of CP was 68 of 9701 (0.7%), with an increasing trend over the two 5.5-year periods studied (24 of 4661 (0.5%) vs 44 of 5040 (0.9%); p=0.035). Factors associated with CP included chronic total occlusions (CTOs) (16 of 68 (24%) vs 993 of 9633 (10%); p<0.001), type C lesions (44 of 68 (65%) vs 4280 of 9633 (44%); p<0.001), use of intravascular ultrasound (IVUS) (12 of 68 (18%) vs 541 of 9633 (6%); p<0.001), cutting balloon angioplasty (3 of 68 (4%) vs 98 of 9633 (1%); p<0.001) and hydrophilic wires (24 of 68 (35%) vs 1454 of 9633 (15%); p<0.001). Cohorts A and B were well matched with respect to age (69±11 vs 70±12 years; p=0.843), sex (males: 13 of 24 (54%) vs 31 of 44 (70%); p=0.179) and renal function (chronic kidney disease: 1 of 24 (4%) vs 4 of 44 (9%); p=0.457). In cohort A, CP was most frequently caused by post-dilatation with non-compliant balloons (10 of 24 (42%); p=0.009); whereas in cohort B, common causes included guidewire exits (23 of 44 (52%)), followed by stent implantation (10 of 44 (23%)). The most common treatment modality in cohorts A and B was balloon inflation, which accounted for 16 of 24 (67%) and 13 of 44 (30%), respectively. The use of covered stents (16%) and coronary coils (18%) during cohort B study period did not impact all-cause mortality, which occurred in 2 of 24 (8%) and 7 of 44 (16%) (p=0.378) in cohorts A and B, respectively. CONCLUSION: The incidence of CP is increasing as more complex PCI is performed. Factors associated with perforation include CTO or type C lesions and use of IVUS, cutting balloon angioplasty or hydrophilic wires.