Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry.
Cardiovasc Revasc Med
; 56: 50-56, 2023 11.
Article
in En
| MEDLINE
| ID: mdl-37357105
ABSTRACT
BACKGROUND:
While previous studies have demonstrated the superiority of ICI-guided PCI over an angiography-based approach, there are limited data on all-comer ACS patients. This study aimed to identify the characteristics and in-hospital outcomes of patients undergoing intracoronary imaging (ICI) guided percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).METHODS:
All patient undergoing PCI for ACS in England and Wales between 2006 and 2019 were retrospectively analyzed and stratified according to ICI utilization. The outcomes assessed were in-hospital all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE) using multivariable logistic regression models.RESULTS:
598,921 patients underwent PCI for ACS, of which 41,716 (7.0 %) had ICI which was predominantly driven by IVUS use (5.6 %). ICI use steadily increased from 1.4 % in 2006 to 13.5 % in 2019. Adjusted odds of mortality (OR 0.69, 95%CI 0.58-0.83) and MACCE (OR 0.77, 95%CI 0.73-0.83) were significantly lower in the ICI group. The association between ICI and improved outcomes varied according to vessel treated with both left main stem (LMS) and LMS/left anterior descending (LAD) PCI associated with significantly lower odds of mortality (OR 0.34, 95%CI 0.27-0.44, OR 0.51 95%CI 0.45-0.56) and MACCE (OR 0.44 95%CI 0.35-0.54, OR 0.67 95%CI 0.62-0.72) respectively.CONCLUSIONS:
Although ICI use has steadily increased, less than one in seven patients underwent ICI-guided PCI. The association between ICI use and improved in-hospital outcomes was mainly observed in PCI procedures involving LMS and LAD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Acute Coronary Syndrome
/
Percutaneous Coronary Intervention
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Cardiovasc Revasc Med
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
United kingdom