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Background Randomized controlled trials concerning pulmonary artery catheters (PACs) use have yielded little evidence of their beneficial effects on survival. This study aimed to evaluate the association between PACs and in-hospital mortality in patients with acute heart failure syndromes (AHFS). Methods The Acute Decompensated Heart Failure Syndromes (ATTEND) Registry is a prospective, observational, multicenter cohort study performed in Japan, since April 2007. We analyzed data from the ATTEND Registry and evaluated the effectiveness of PAC in AHFS treatment using propensity score-matching and the Cox proportional hazards model. Results Final follow-up examinations of the 4842 patients were conducted in December 2012. During the study period, 813 patients (16.8%) were managed with PACs, of which 502 patients (PAC group) were propensity score-matched with 502 controls (Control group). Of the 1004 score-matched patients, 22 (4.4%) patients from the Control group and 7 (1.4%) from the PAC group died. The risk of all-cause death was lower in the PAC group than that in the Control group [hazard ratio (HR), 0.3; 95% confidence interval (CI), 0.13–0.70; p=0.006]. PAC-guided therapy decreased all-cause mortality in patients with lower systolic blood pressure (SBP≤100mmHg; HR, 0.09; 95% CI, 0.01–0.70; p=0.021) or inotropic therapy (HR, 0.22; 95% CI, 0.08–0.57; p=0.002). Conclusions This study revealed that appropriate PAC use effectively decreases in-hospital mortality in AHFS patients, particularly those with lower SBP or receiving inotropic therapy, suggesting that real-world PAC use could improve AHFS management.

a Division of Cardiology, Sensoji Hospital, Tokyo, Japan b Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan c Department of Cardiovascular Medicine, Edogawa Hospital, Tokyo, Japan d Department of Cardiology, Osaka University Graduate School of Medicine, Osaka, Japan e Department of Internal Medicine, Nippon Medical School, Tokyo, Japan f Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan

Background Although measurement of stent strut by optical coherence tomography (OCT) is important as an index for evaluating incomplete stent apposition, the effects of drug-eluting stents (DES) polymer on it are unknown. Methods and results DES and bare-metal stents (BMS) as platforms of DES were implanted in an artificial artery. Thickness of stent strut, defined as a distance from inner surface of the strut to the adjacent surface of the tube, and thickness of high-signal band were measured by OCT. Each measurement of DES was significantly larger comparing with BMS. Conclusion This in-vitro study demonstrates that DES polymer may influence OCT measurement for the stent strut.