Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention: Trends and Outcomes 2010-2019 |
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| Affiliation: | 1. Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE;2. Department of Clinical Research, Creighton University, Omaha, NE;3. Department of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, NE;4. Department of Interventional Cardiology, Icahn School of Medicine at Mount Sinai Morningside and Beth Israel, New York, NY;5. Department of Medicine, Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC;6. Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE;1. Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska;2. Division of Cardiovascular Medicine, Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska;3. Division of Cardiovascular Medicine, Department of Medicine, Sacred Heart Medical Center, Springfield, Oregon;4. Division of Cardiovascular Medicine, Department of Medicine, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire;5. Division of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut;6. Lifespan Cardiovascular Institute, Alpert Medical School of Brown University, Providence, Rhode Island;7. Division of Cardiovascular Medicine, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska;1. John Ochsner Heart and Vascular Center, New Orleans, LA, USA;2. Department of Cardiology, Montefiore Medical Center, NY, USA;3. Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia, PA, USA;4. Department of Internal Medicine, Lincoln Medical Centre, New York, NY, USA;5. Boston University, Masters of Public Health, Boston, MA, USA;6. Department of Internal Medicine, University of Maryland Capital Regional Medical Centre, Lake Arbor, MD, USA;7. The University of Queensland Ochsner Clinical School, Faculty of Medicine, The University of Queensland, New Orleans, LA, USA;1. Department of Cardiology, Ochsner Medical Center, New Orleans, LA;2. King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia;3. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA;1. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy. Cardiology Unit, University Hospital “P. Giaccone”, Palermo, Italy;2. Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria, CHULN, Portugal;3. Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy;4. University of Liège Hospital, GIGA Cardiovascular Sciences, Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium;1. Federal State Budgetary Scientific Institution "Russian Scientific Center of Surgery named B.V. Petrovsky", Moscow, Russian Federation;2. City Alexandrovskaya Hospital, Saint Petersburg, Russian Federation;3. Federal State Budgetary Educational Institution of Higher Education, Military Medical Academy named after SM. Kirov, Saint Petersburg, Russian Federation;4. North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation;5. Research Institute Regional Clinical Hospital No. 1 named. prof. S.V. Ochapovsky , Krasnodar, Russian Federation;6. Department of Surgery No. 1 FPK and teaching staff of the Kuban State Medical University, Krasnodar, Russian Federation;7. Clinic of cardiac surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation;8. Clinic of high medical technologies named after N.I. Pirogov St. Petersburg State University, Saint Petersburg, Russian Federation;9. Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation;10. Kemerovo Regional Clinical Hospital named after S.V. Belyaeva, Kemerovo, Russian Federation;1. Hospitalist, Department of Medicine, Baptist Memorial Hospital, Memphis, TN;2. Student, Rollins School of Public Health, Emory University, Atlanta, GA;3. Resident, Department of Internal Medicine, University of University of Kansas - Wichita program, Wichita, KS;4. Medical Student, College of Medicine, University of Tennessee Health Science Center, Memphis, TN;5. Resident, Department of Internal Medicine, Lenox Hill Hospital, New York, NY;6. Program Director, Interventional Cardiology, University of Tennessee Health Science Center, Memphis, TN;7. Associate Program Director, Cardiology Fellowship, University of Tennessee Health Science Center, Memphis, TN;8. Director, Cardiac Cath Labs, Methodist University Hospital, Memphis, TN |
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| Abstract: | ![]()
Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) optimize percutaneous coronary intervention (PCI) by characterizing lesion morphology, accurately measuring vessel dimensions, and optimizing stent characteristics. We sought to compare the utilization of OCT and IVUS to guide inpatient PCI and their relative association with in-hospital mortality and readmission rates. We queried the National Readmission Database to identify patients undergoing intracoronary imaging-guided PCI from 2010 to 2019 and compared outcomes and readmission rates between patients undergoing OCT-guided PCI and IVUS-guided PCI. Multivariable logistic regression was performed to generate adjusted odds ratios (aOR) of adverse outcomes between the 2 groups. Of 3,71,450 intracoronary imaging-guided PCI admissions, OCT (n = 12,808) was used less frequently than IVUS (n = 358,642). The use of OCT-guided PCI increased from 0.1% in 2010 to 0.6% in 2019 while the rate of IVUS-guided PCI increased from 7.2% in 2010 to 9.4% in 2019 (both ptrend <0.001). Patients undergoing OCT compared to IVUS had lower in-hospital mortality (aOR 0.69, P = 0.015) and 30-day readmission rate (aOR 0.91, P = 0.040) with no statistical difference in 90-day readmission rate (aOR 0.93, P = 0.065). Heart failure was the most common cause of 30-day and 90-day readmissions in both cohorts. There was no difference in the rate of acute kidney injury between the 2 modalities. In this in-patient admission database of intracoronary imaging-guided PCI, OCT-guided PCI during index hospitalization appears to be associated with lower in-hospital mortality and 30-day readmission rates compared to IVUS-guided PCI with no difference in terms of the 90-day readmission rates. |
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