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Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups

BACKGROUND: Intracoronary imaging (ICI) has been shown to improve survival after percutaneous coronary intervention (PCI). Whether this prognostic benefit is sustained across different indications remains unclear. METHODS AND RESULTS: All PCI procedures performed in England and Wales between April,...

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Autores principales: Mohamed, Mohamed O., Kinnaird, Tim, Wijeysundera, Harindra C., Johnson, Thomas W., Zaman, Sarah, Rashid, Muhammad, Moledina, Saadiq, Ludman, Peter, Mamas, Mamas A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673688/
https://www.ncbi.nlm.nih.gov/pubmed/36172967
http://dx.doi.org/10.1161/JAHA.122.026500
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author Mohamed, Mohamed O.
Kinnaird, Tim
Wijeysundera, Harindra C.
Johnson, Thomas W.
Zaman, Sarah
Rashid, Muhammad
Moledina, Saadiq
Ludman, Peter
Mamas, Mamas A.
author_facet Mohamed, Mohamed O.
Kinnaird, Tim
Wijeysundera, Harindra C.
Johnson, Thomas W.
Zaman, Sarah
Rashid, Muhammad
Moledina, Saadiq
Ludman, Peter
Mamas, Mamas A.
author_sort Mohamed, Mohamed O.
collection PubMed
description BACKGROUND: Intracoronary imaging (ICI) has been shown to improve survival after percutaneous coronary intervention (PCI). Whether this prognostic benefit is sustained across different indications remains unclear. METHODS AND RESULTS: All PCI procedures performed in England and Wales between April, 2014 and March 31, 2020, were retrospectively analyzed. The association between ICI use and in‐hospital major acute cardiovascular and cerebrovascular events; composite of all‐cause mortality, stroke, and reinfarction and mortality was examined using multivariable logistic regression analysis for different imaging‐recommended indications as set by European Association for Percutaneous Cardiovascular Interventions consensus. Of 555 398 PCI procedures, 10.8% (n=59 752) were ICI‐guided. ICI use doubled between 2014 (7.8%) and 2020 (17.5%) and was highest in left main PCI (41.2%) and lowest in acute coronary syndrome (9%). Only specific European Association for Percutaneous Cardiovascular Interventions imaging‐recommended indications were associated with reduced major acute cardiovascular and cerebrovascular events and mortality, including left main PCI (odds ratio [OR], 0.45 [95% CI, 0.39–0.52] and 0.41 [95% CI, 0.35–0.48], respectively), acute coronary syndrome (OR, 0.76 [95% CI, 0.70–0.82] and 0.70 [95% CI, 0.63–0.77]), and stent length >60 mm (OR, 0.75 [95% CI, 0.59–0.94] and 0.72 [95% CI, 0.54–0.95]). Stent thrombosis and renal failure were associated with lower mortality (OR, 0.69 [95% CI, 0.52–0.91]) and major acute cardiovascular and cerebrovascular events (OR, 0.77 [95% CI, 0.60–0.99]), respectively. CONCLUSIONS: ICI use has more than doubled over a 7‐year period at a national level but remains low, with <1 in 5 procedures performed under ICI guidance. In‐hospital survival was better with ICI‐guided than angiography‐guided PCI, albeit only for specific indications.
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spelling pubmed-96736882022-11-21 Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups Mohamed, Mohamed O. Kinnaird, Tim Wijeysundera, Harindra C. Johnson, Thomas W. Zaman, Sarah Rashid, Muhammad Moledina, Saadiq Ludman, Peter Mamas, Mamas A. J Am Heart Assoc Original Research BACKGROUND: Intracoronary imaging (ICI) has been shown to improve survival after percutaneous coronary intervention (PCI). Whether this prognostic benefit is sustained across different indications remains unclear. METHODS AND RESULTS: All PCI procedures performed in England and Wales between April, 2014 and March 31, 2020, were retrospectively analyzed. The association between ICI use and in‐hospital major acute cardiovascular and cerebrovascular events; composite of all‐cause mortality, stroke, and reinfarction and mortality was examined using multivariable logistic regression analysis for different imaging‐recommended indications as set by European Association for Percutaneous Cardiovascular Interventions consensus. Of 555 398 PCI procedures, 10.8% (n=59 752) were ICI‐guided. ICI use doubled between 2014 (7.8%) and 2020 (17.5%) and was highest in left main PCI (41.2%) and lowest in acute coronary syndrome (9%). Only specific European Association for Percutaneous Cardiovascular Interventions imaging‐recommended indications were associated with reduced major acute cardiovascular and cerebrovascular events and mortality, including left main PCI (odds ratio [OR], 0.45 [95% CI, 0.39–0.52] and 0.41 [95% CI, 0.35–0.48], respectively), acute coronary syndrome (OR, 0.76 [95% CI, 0.70–0.82] and 0.70 [95% CI, 0.63–0.77]), and stent length >60 mm (OR, 0.75 [95% CI, 0.59–0.94] and 0.72 [95% CI, 0.54–0.95]). Stent thrombosis and renal failure were associated with lower mortality (OR, 0.69 [95% CI, 0.52–0.91]) and major acute cardiovascular and cerebrovascular events (OR, 0.77 [95% CI, 0.60–0.99]), respectively. CONCLUSIONS: ICI use has more than doubled over a 7‐year period at a national level but remains low, with <1 in 5 procedures performed under ICI guidance. In‐hospital survival was better with ICI‐guided than angiography‐guided PCI, albeit only for specific indications. John Wiley and Sons Inc. 2022-09-29 /pmc/articles/PMC9673688/ /pubmed/36172967 http://dx.doi.org/10.1161/JAHA.122.026500 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Mohamed, Mohamed O.
Kinnaird, Tim
Wijeysundera, Harindra C.
Johnson, Thomas W.
Zaman, Sarah
Rashid, Muhammad
Moledina, Saadiq
Ludman, Peter
Mamas, Mamas A.
Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title_full Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title_fullStr Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title_full_unstemmed Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title_short Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
title_sort impact of intracoronary imaging‐guided percutaneous coronary intervention on procedural outcomes among complex patient groups
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673688/
https://www.ncbi.nlm.nih.gov/pubmed/36172967
http://dx.doi.org/10.1161/JAHA.122.026500
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