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Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry

Lookup NU author(s): Dr Javed Ahmed

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2023 The AuthorsBackground: 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.

Publication metadata

Author(s): Zaman M, Stevens C, Ludman P, Wijeysundera HC, Siudak Z, Sharp ASP, Kinnaird T, Mohamed MO, Ahmed JM, Rashid M, Mamas MA

Publication type: Article

Publication status: Published

Journal: Cardiovascular Revascularization Medicine

Year: 2023

Pages: epub ahead of print

Online publication date: 29/05/2023

Acceptance date: 25/05/2023

Date deposited: 10/07/2023

ISSN (print): 1553-8389

ISSN (electronic): 1878-0938

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.carrev.2023.05.020

DOI: 10.1016/j.carrev.2023.05.020

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