TY - JOUR
T1 - Trends and Outcomes of Uilization of Thrombectomy During Primary Percutaneous Coronary Intervention
AU - Megaly, Michael
AU - Sedhom, Ramy
AU - Elbadawi, Ayman
AU - Saad, Marwan
AU - Omer, Mohamed
AU - Brilakis, Emmanouil S.
AU - Basir, Mir B.
AU - Jaffer, Farouc A.
AU - Zaidan, Mohammad
AU - Alqarqaz, Mohammad
AU - Alaswad, Khaldoon
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/3
Y1 - 2022/3
N2 - Background: To describe the national trends and outcomes of contemporary thrombectomy use for primary percutaneous coronary intervention (PCI) from 2016 to 2018. Methods: We queried the Nationwide Readmission Database (NRD) from January 2016 to December 2018 to identify patients who underwent primary PCI and thrombectomy. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality and stroke in patients undergoing primary PCI and those who underwent thrombectomy. Results: We identified 409,910 total hospitalizations who underwent primary PCI. Thrombectomy was used in 62,446 records (15.2%) with no change in the trend over the study period (p trend = 0.52). Thrombectomy was more utilized in patients who had more cardiogenic shock and use of mechanical circulatory devices. The overall incidence of in-hospital mortality and stroke were 5.6% and 1.1%, respectively. The incidence of in-hospital mortality (6.7% vs. 5.4%, p < 0.001) and strokes (1.3% vs. 1.0%, p < 0.001) were higher in the thrombectomy group. On multivariable regression analysis adjusting for high-risk features, thrombectomy was not independently associated with in-hospital mortality [1.036, 95% CI (0.993–1.080), p = 0.100], but was associated with a higher risk of stroke [OR 1.186, 95% CI (1.097–1.283), p < 0.001]. Conclusion: During primary PCI, thrombectomy was used in 1 of 6 cases, and its use has been stable over 2016–2018. The use of thrombectomy was associated with a higher risk of stroke, but not in-hospital death.
AB - Background: To describe the national trends and outcomes of contemporary thrombectomy use for primary percutaneous coronary intervention (PCI) from 2016 to 2018. Methods: We queried the Nationwide Readmission Database (NRD) from January 2016 to December 2018 to identify patients who underwent primary PCI and thrombectomy. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality and stroke in patients undergoing primary PCI and those who underwent thrombectomy. Results: We identified 409,910 total hospitalizations who underwent primary PCI. Thrombectomy was used in 62,446 records (15.2%) with no change in the trend over the study period (p trend = 0.52). Thrombectomy was more utilized in patients who had more cardiogenic shock and use of mechanical circulatory devices. The overall incidence of in-hospital mortality and stroke were 5.6% and 1.1%, respectively. The incidence of in-hospital mortality (6.7% vs. 5.4%, p < 0.001) and strokes (1.3% vs. 1.0%, p < 0.001) were higher in the thrombectomy group. On multivariable regression analysis adjusting for high-risk features, thrombectomy was not independently associated with in-hospital mortality [1.036, 95% CI (0.993–1.080), p = 0.100], but was associated with a higher risk of stroke [OR 1.186, 95% CI (1.097–1.283), p < 0.001]. Conclusion: During primary PCI, thrombectomy was used in 1 of 6 cases, and its use has been stable over 2016–2018. The use of thrombectomy was associated with a higher risk of stroke, but not in-hospital death.
KW - Primary PCI
KW - STEMI
KW - Stroke
KW - Thrombectomy
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U2 - 10.1016/j.carrev.2021.05.021
DO - 10.1016/j.carrev.2021.05.021
M3 - Article
C2 - 34167914
AN - SCOPUS:85109101130
SN - 1553-8389
VL - 36
SP - 83
EP - 88
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -