Percutaneous coronary intervention involving coronary bifurcation is associated with higher mortality and complications.

IF 1.3
American journal of cardiovascular disease Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI:10.62347/XDDB4510
Allistair Nathan, Mehrtash Hashemzadeh, Mohammad Reza Movahed
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引用次数: 0

Abstract

Background: Percutaneous coronary intervention (PCI) in patients with bifurcation lesions is associated with higher complexity and adverse outcomes. The goal of this study was to evaluate the inpatient outcomes of patients with PCI of bifurcation lesions.

Methods: The National Inpatient Sample (NIS) database, years 2016-2020, was studied using ICD 10 codes. Patients undergoing PCI for bifurcation lesions were compared to those undergoing PCI for non-bifurcation lesions, excluding chronic total occlusion lesions. We evaluated post-procedural inpatient mortality and complications.

Results: PCI in patients with bifurcation lesions was associated with higher mortality and post-procedural complications. A weighted total of 9,795,154 patients underwent PCI; of those, 43,480 had a bifurcation lesion. The bifurcation cohort had a 3.79% mortality rate, and the rate in those with non-bifurcation lesions was 2.56% (OR, 1.50; CI: 1.34-1.68; P<0.001). Upon conducting multivariate analysis, which adjusted for age, sex, race, and significant comorbidities, PCI for bifurcation lesions remained significantly associated with a higher mortality rate compared to non-bifurcation lesion PCI (OR, 1.68; 95% CI, 1.49-1.88; P<0.001). Furthermore, PCI for bifurcation lesions was associated with higher rates of myocardial infarction (OR, 2.26; 95% CI, 1.68-3.06; P<0.001), coronary perforation (OR, 7.97; 95% CI, 6.25-10.17; P<0.001), tamponade (OR, 3.46; 95% CI, 2.49-4.82; P<0.001), and procedural bleeding (OR, 5.71; 95% CI, 4.85-6.71; P<0.001). Overall, post-procedural complications were 4 times more in patients with bifurcation lesions than in those without (OR, 4.33; 95% CI, 3.83-4.88; P<0.001).

Conclusion: Using a large, national inpatient database, we demonstrate that both mortality rates and post-procedural complication rates were significantly higher in patients undergoing PCI for bifurcation lesions than in those undergoing PCI for non-bifurcation lesions.

涉及冠状动脉分叉的经皮冠状动脉介入治疗与较高的死亡率和并发症有关。
背景:对分叉病变患者进行经皮冠状动脉介入治疗(PCI)与较高的复杂性和不良预后相关。本研究旨在评估二叉病变 PCI 患者的住院预后:使用 ICD 10 代码对 2016-2020 年全国住院患者样本(NIS)数据库进行研究。将接受PCI治疗分叉病变的患者与接受PCI治疗非分叉病变的患者(不包括慢性全闭塞病变)进行比较。我们评估了手术后的住院死亡率和并发症:结果:对有分叉病变的患者进行 PCI 与较高的死亡率和术后并发症有关。加权后共有9795154名患者接受了PCI手术,其中43480名患者有分叉病变。二叉病变患者的死亡率为3.79%,而非二叉病变患者的死亡率为2.56%(OR,1.50;CI:1.34-1.68;PC结论:通过使用大型全国住院患者数据库,我们证明了因分叉病变接受 PCI 治疗的患者死亡率和术后并发症发生率均明显高于因非分叉病变接受 PCI 治疗的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American journal of cardiovascular disease
American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-
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