Use of intravascular imaging in patients with ST-segment elevation acute myocardial infarction

Michael Megaly, Ashish Pershad, Matthew Glogoza, Ayman Elbadawi, Mohamed Omer, Marwan Saad, Amgad Mentias, Islam Elgendy, M. Nicholas Burke, Davide Capodanno, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The use and impact of intravascular imaging in ST-elevation myocardial infarction (STEMI) patients has received limited study. Methods: We queried the National Inpatient Sample database (NIS) between January 2016 and December 2017 to identify hospitalizations of STEMI patients who underwent percutaneous coronary intervention (PCI). We used a 1:2 propensity-score (PS) matched analysis to compare in-hospital outcomes in patients with vs. without use of intravascular imaging. We conducted a multivariable regression analysis to identify variables independently associated with in-hospital mortality. Results: We identified 252,970 weighted discharges of PCI in STEMI patients, 5.5% of which included intravascular imaging. Patients in whom intravascular imaging was used were more likely to have acute stent thrombosis (4.7% vs. 1.4%, p < 0.001) and present with anterior STEMI (48.1% vs. 39.1%, p < 0.001). After PS matching (intravascular imaging n = 14,015, no intravascular imaging n = 28,025), the use of intravascular imaging was associated with lower in-hospital mortality (3.6% vs. 4.8%, p = 0.010). The risk of in-hospital complications and discharge to a facility (nursing facility or short-term acute hospital) was similar between both groups before and after PS matching. The use of intravascular imaging was associated with a higher index hospitalization cost [$25,218 vs. $20,515, p < 0.001]. On multivariable analysis, intravascular imaging was independently associated with lower in-hospital mortality [OR 0.735 (95% CI 0.662–0.816), p < 0.001]. Conclusion: Intravascular imaging was used in 5.5% of PCIs in STEMI patients and was independently associated with lower in-hospital mortality and higher index hospitalization cost.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - 2020

Keywords

  • Intravascular imaging
  • Intravascular ultrasound
  • IVUS
  • OCT
  • Optical coherence tomography
  • STEMI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Use of intravascular imaging in patients with ST-segment elevation acute myocardial infarction'. Together they form a unique fingerprint.

Cite this