| Title: |
Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry |
| Authors: |
Zaman, M; Stevens, C; Ludman, P; Wijeysundera, HC; Siudak, Z; Sharp, ASP; Kinnaird, T; Mohamed, MO; Ahmed, JM; Rashid, M; Mamas, MA |
| Source: |
Cardiovascular Revascularization Medicine (2023) (In press). |
| Publisher Information: |
Elsevier BV |
| Publication Year: |
2023 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Acute coronary syndrome; In-hospital mortality; Intracoronary imaging; Intravascular ultrasound; Optical coherence tomography |
| Description: |
Background: While previous studies have demonstrated the superiority of ICI-guided PCI over an angiography-based approach, there are limited data on all-comer ACS patients. This study aimed to identify the characteristics and in-hospital outcomes of patients undergoing intracoronary imaging (ICI) guided percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods: All patient undergoing PCI for ACS in England and Wales between 2006 and 2019 were retrospectively analyzed and stratified according to ICI utilization. The outcomes assessed were in-hospital all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE) using multivariable logistic regression models. Results: 598,921 patients underwent PCI for ACS, of which 41,716 (7.0 %) had ICI which was predominantly driven by IVUS use (5.6 %). ICI use steadily increased from 1.4 % in 2006 to 13.5 % in 2019. Adjusted odds of mortality (OR 0.69, 95%CI 0.58–0.83) and MACCE (OR 0.77, 95%CI 0.73–0.83) were significantly lower in the ICI group. The association between ICI and improved outcomes varied according to vessel treated with both left main stem (LMS) and LMS/left anterior descending (LAD) PCI associated with significantly lower odds of mortality (OR 0.34, 95%CI 0.27–0.44, OR 0.51 95%CI 0.45–0.56) and MACCE (OR 0.44 95%CI 0.35–0.54, OR 0.67 95%CI 0.62–0.72) respectively. Conclusions: Although ICI use has steadily increased, less than one in seven patients underwent ICI-guided PCI. The association between ICI use and improved in-hospital outcomes was mainly observed in PCI procedures involving LMS and LAD. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10173164/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10173164/1/1-s2.0-S1553838923002117-main.pdf; https://discovery.ucl.ac.uk/id/eprint/10173164/ |
| Rights: |
open |
| Accession Number: |
edsbas.65E11E58 |
| Database: |
BASE |