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Trends in the Outcomes of High-risk Percutaneous Ventricular Assist Device-assisted Percutaneous Coronary Intervention, 2008-2018.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2021 Oct 01; Vol. 156, pp. 65-71. Date of Electronic Publication: 2021 Jul 31. - Publication Year :
- 2021
-
Abstract
- Percutaneous ventricular assist devices (pVAD) are frequently utilized in high-risk percutaneous coronary intervention (HR-PCI) to provide hemodynamic support in patients with complex cardiovascular disease and/or multiple comorbidities who are poor candidates for surgical revascularization. Using the National Inpatient Sample we identified pVAD-assisted PCI (excluding intra-aortic balloon pump) in patients without cardiogenic shock from January 2008 to December 2018. We evaluated the trends in patient and procedural characteristics, and complication rates across the 11-year study period. A total of 26,661 pVAD-PCI was performed. From 2008 to 2018 there has was a 27-fold increase in the number of pVAD-PCIs performed annually. There has also been an increase in the proportion of procedures performed in small to medium sized hospitals. The use of atherectomy, image-guided PCI, FFR/iFR, drug-eluting stents, and multi-vessel intervention has significantly increased. Patients undergoing pVAD-PCI had a higher burden of comorbidities, without a significant difference in mortality over time. There were decreased rates of acute stroke and blood transfusions over time, while vascular complications and acute kidney injury (AKI) requiring dialysis remained mostly unchanged. In conclusion, the use of pVAD for HR-PCI has increased significantly, along with adjunctive PCI techniques such as atherectomy, intravascular imaging, and physiologic lesion assessment. With increasing use of this device, there appeared to be lower rates of peri-procedural stroke, and blood transfusions. Despite a higher burden of comorbidities, adjusted mortality remained stable over time.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Coronary Artery Disease complications
Coronary Artery Disease physiopathology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Factors
Shock, Cardiogenic epidemiology
Shock, Cardiogenic etiology
Survival Rate trends
Treatment Outcome
United States epidemiology
Coronary Artery Disease surgery
Heart-Assist Devices
Hemodynamics physiology
Percutaneous Coronary Intervention methods
Shock, Cardiogenic prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 156
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 34344515
- Full Text :
- https://doi.org/10.1016/j.amjcard.2021.06.048