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Trends and Outcomes of Intravascular Imaging-guided Percutaneous Coronary Intervention in the United States
- Source :
- Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 19:69-74
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- INTRODUCTION Intravascular imaging-guided percutaneous coronary intervention (PCI) has shown to improve outcomes in randomized controlled trials. However, there are little real-world data about intravascular imaging utilization during PCI and its outcomes in the United States. METHODS We conducted an observational analysis on the use of intravascular imaging (Intravascular Ultrasound or Optical Coherence Tomography)-guided PCI in 2,425,036 patients undergoing PCI between January 2010 and December 2014 from the Nationwide Inpatient Sample database. Utilizing propensity score matching, 83,988 matched pairs were identified. The primary outcome was in-hospital mortality. The secondary outcomes included cardiogenic shock and acute kidney injury. RESULTS Among the 2,425,036 patients, 161,808 (6.7%) underwent imaging-guided PCI. Use of imaging-guidance increased from 6% in 2010 to 6.6% in 2014 (Ptrend < 0.001). The in-hospital mortality was significantly different between imaging-guided PCI and angiography-guided PCI [1.0% vs. 1.5%; adjusted OR: 0.67; 95% confidence interval (CI): 0.54-0.83, P < 0.001]. The rates of cardiogenic shock (2.5% vs. 3.1%; adjusted OR: 0.78; 95% CI: 0.66-0.93; P = 0.005) were significantly lower in imaging-guided PCI group and acute kidney injury rates (7.0% vs. 7.1%; adjusted OR: 0.99; 95% CI: 0.89-1.12; P = 0.919) were not significantly different. CONCLUSIONS Imaging-guided PCI is associated with lower in-hospital mortality. Yet, a small proportion of patients undergoing PCI have imaging-guidance.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Shock, Cardiogenic
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
law.invention
Young Adult
03 medical and health sciences
Percutaneous Coronary Intervention
Postoperative Complications
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Intravascular ultrasound
Odds Ratio
medicine
Humans
Hospital Mortality
Hospital Costs
Propensity Score
Ultrasonography, Interventional
Aged
medicine.diagnostic_test
business.industry
Cardiogenic shock
Acute kidney injury
Percutaneous coronary intervention
Acute Kidney Injury
Length of Stay
Middle Aged
medicine.disease
United States
Confidence interval
Surgery, Computer-Assisted
Conventional PCI
Propensity score matching
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Tomography, Optical Coherence
Subjects
Details
- ISSN :
- 1535282X
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine
- Accession number :
- edsair.doi.dedup.....001274c936dce1d2da0f90aceafb001e