The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database

Introduction. There is increasing evidence supporting the use of intracoronary imaging to optimize the outcomes of percutaneous coronary intervention (PCI). However, there are no studies examining the impact of imaging on PCI outcomes in cases utilising rotational atherectomy (RA-PCI). Our study exa...

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Main Authors: Majd B. Protty, Sean Gallagher, Andrew S. P. Sharp, Vasim Farooq, Mohaned Egred, Peter O’Kane, Peter Ludman, Mamas A Mamas, Tim Kinnaird
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2022/5879187
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author Majd B. Protty
Sean Gallagher
Andrew S. P. Sharp
Vasim Farooq
Mohaned Egred
Peter O’Kane
Peter Ludman
Mamas A Mamas
Tim Kinnaird
author_facet Majd B. Protty
Sean Gallagher
Andrew S. P. Sharp
Vasim Farooq
Mohaned Egred
Peter O’Kane
Peter Ludman
Mamas A Mamas
Tim Kinnaird
author_sort Majd B. Protty
collection DOAJ
description Introduction. There is increasing evidence supporting the use of intracoronary imaging to optimize the outcomes of percutaneous coronary intervention (PCI). However, there are no studies examining the impact of imaging on PCI outcomes in cases utilising rotational atherectomy (RA-PCI). Our study examines the determinants and outcomes of using intracoronary imaging in RA-PCI cases including 12-month mortality. Methods. Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in the UK between 2007 and 2014. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural, and outcome associations with intravascular imaging. Results. Intracoronary imaging was used in 1,279 out of 8,417 RA-PCI cases (15.2%). Baseline covariates associated with significantly more imaging use were number of stents used, smoking history, previous CABG, pressure wire use, proximal LAD disease, laser use, glycoprotein inhibitor use, cutting balloons, number of restenosis attempted, off-site surgery, and unprotected left main stem (uLMS) PCI. Adjusted rates of in-hospital major adverse cardiac/cerebrovascular events (IH-MACCE), its individual components (death, peri-procedural MI, stroke, and major bleed), or 12-month mortality were not significantly altered by the use of imaging in RA-PCI. However, subgroup analysis demonstrated a signal towards reduction in 12-month mortality in uLMS RA-PCI cases utilising intracoronary imaging (OR 0.67, 95% CI 0.44–1.03). Conclusions. Intracoronary imaging use during RA-PCI is associated with higher risk of baseline and procedural characteristics. There were no differences observed in IH-MACCE or 12-month mortality with intracoronary imaging in RA-PCI.
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spelling doaj-art-4ae144356fae4784909f6c719b2f49c92025-02-03T06:01:51ZengWileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/5879187The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society DatabaseMajd B. Protty0Sean Gallagher1Andrew S. P. Sharp2Vasim Farooq3Mohaned Egred4Peter O’Kane5Peter Ludman6Mamas A Mamas7Tim Kinnaird8Department of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyCardiothoracic DepartmentDepartment of CardiologyInstitute of Cardiovascular SciencesKeele Cardiovascular Research GroupDepartment of CardiologyIntroduction. There is increasing evidence supporting the use of intracoronary imaging to optimize the outcomes of percutaneous coronary intervention (PCI). However, there are no studies examining the impact of imaging on PCI outcomes in cases utilising rotational atherectomy (RA-PCI). Our study examines the determinants and outcomes of using intracoronary imaging in RA-PCI cases including 12-month mortality. Methods. Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in the UK between 2007 and 2014. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural, and outcome associations with intravascular imaging. Results. Intracoronary imaging was used in 1,279 out of 8,417 RA-PCI cases (15.2%). Baseline covariates associated with significantly more imaging use were number of stents used, smoking history, previous CABG, pressure wire use, proximal LAD disease, laser use, glycoprotein inhibitor use, cutting balloons, number of restenosis attempted, off-site surgery, and unprotected left main stem (uLMS) PCI. Adjusted rates of in-hospital major adverse cardiac/cerebrovascular events (IH-MACCE), its individual components (death, peri-procedural MI, stroke, and major bleed), or 12-month mortality were not significantly altered by the use of imaging in RA-PCI. However, subgroup analysis demonstrated a signal towards reduction in 12-month mortality in uLMS RA-PCI cases utilising intracoronary imaging (OR 0.67, 95% CI 0.44–1.03). Conclusions. Intracoronary imaging use during RA-PCI is associated with higher risk of baseline and procedural characteristics. There were no differences observed in IH-MACCE or 12-month mortality with intracoronary imaging in RA-PCI.http://dx.doi.org/10.1155/2022/5879187
spellingShingle Majd B. Protty
Sean Gallagher
Andrew S. P. Sharp
Vasim Farooq
Mohaned Egred
Peter O’Kane
Peter Ludman
Mamas A Mamas
Tim Kinnaird
The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
Journal of Interventional Cardiology
title The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
title_full The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
title_fullStr The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
title_full_unstemmed The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
title_short The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database
title_sort impact of intracoronary imaging on pci outcomes in cases utilising rotational atherectomy an analysis of 8 417 rotational atherectomy cases from the british cardiovascular intervention society database
url http://dx.doi.org/10.1155/2022/5879187
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