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 - Funding Information:
Emmanouil Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), ControlRad, CSI, Ebix, Elsevier, GE Healthcare, InfraRedx, Medtronic, Siemens, and Teleflex; research support from Regeneron and Siemens. Shareholder: MHI Ventures.
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
VL - 36
SP - 83
EP - 88
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
ER -