Characteristics and hospital outcomes of coronary atherectomy within the United States: a multivariate and propensity-score matched analysis

Fahed Darmoch, Waqas Ullah, Yasser Al-khadra, Yasar Sattar, Homam Moussa Pacha, Mohamed Zghouzi, Mohamad Soud, Rodrigo Bagur, Srihari S. Naidu, Andrew M. Goldsweig, Mamas Mamas, Emmanouil S. Brilakis, M. Chadi Alraies

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Suboptimal stent delivery and deployment in calcified coronary lesions are associated with a poor clinical outcome. Methods: Using the National Inpatient Sample database, we identified patients undergoing percutaneous coronary intervention (PCI). Comparison between procedural and hospital outcomes between patients who underwent atherectomy and those who did not. Results: A total of 2,035,039 patients underwent PCI, of which 50,095 (2.4%) underwent lesion modification using atherectomy. After adjustment for baseline differences, patients who underwent atherectomy were found to have higher rates of in-hospital mortality (3.3% vs 2.2% adjusted Odds Ratio, aOR, 1.39; 95% confidence interval [CI], 1.31–1.46, P < 0.001), coronary artery dissection (1.7% vs 1.1%, aOR, 1.56; 95%, 1.45–1.67, P < 0.001) vascular complications (1.6% vs 1.0%, aOR, 1.52; 95%, 1.42–1.64, P < 0.001), major bleeding (6.3% vs 4.7%, aOR, 1.24; 95%, 1.18–1.28, P < 0.001), and acute kidney injury (AKI) (10.9%vs 9.1%, aOR, 1.07; 95%, 1.04–1.11, P < 0.001) when compared with non-atherectomy patients. Concomitant intravascular ultrasound (IVUS) imaging improved mortality, while other complication rates were not affected by imaging. Conclusion: Coronary atherectomy was performed in patients with multiple comorbidities and was associated with higher in-hospital mortality and complications than the non-atherectomy group.

Original languageEnglish (US)
Pages (from-to)865-870
Number of pages6
JournalExpert Review of Cardiovascular Therapy
Volume19
Issue number9
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Atherectomy
  • intravascular ultrasound imaging
  • IVUS
  • PCI
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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