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Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry

Zaman, M; Stevens, C; Ludman, P; Wijeysundera, HC; Siudak, Z; Sharp, ASP; Kinnaird, T; ... Mamas, MA; + view all (2023) Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry. Cardiovascular Revascularization Medicine 10.1016/j.carrev.2023.05.020. (In press). Green open access

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Abstract

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.

Type: Article
Title: Intracoronary imaging in PCI for acute coronary syndrome: Insights from British Cardiovascular Intervention Society registry
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.carrev.2023.05.020
Publisher version: https://doi.org/10.1016/j.carrev.2023.05.020
Language: English
Additional information: © 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Acute coronary syndrome, In-hospital mortality, Intracoronary imaging, Intravascular ultrasound, Optical coherence tomography
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/10173164
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