Predicting Temporal Trends and Hospital-Level Variation in Calcium Modification Strategies Adoption in Percutaneous Coronary Intervention.

Omar M Abdelfattah, Omar Chaabo, Joe Aoun, Umamahesh Rangasetty, Alpesh R Shah
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Abstract

Background: The adoption patterns of novel cardiovascular interventional technologies significantly impact patient care and health care resource allocation. This study analyzes and projects the adoption trends of intravascular lithotripsy (IVL) compared to coronary atherectomy (CA).

Objectives: The objective of the study was to investigate the predicted utilization trends of various calcium modification strategies by year 2035.

Methods: Leveraging data from multiple U.S.-based registries (2009-2022), we developed Monte Carlo simulations (n = 100,000 simulated iterations) to model adoption trends and hospital-level variations. Logistic growth models were used to project technology adoption rates through 2035.

Results: IVL showed rapid adoption with a projected terminal rate of 32.41% by year 2035 (95% CI: 28.76% to 36.06%) and mean annual growth of 2.5% (95% CI: 2.1% to 2.9%). CA (rotational and orbital) adoption is projected to reach 4.5 to 5.5% by 2035 (10% to 90% CI: 3.8% to 6.2%). Hospital-level analysis revealed increasing variability in adoption patterns, with high-volume centers (>10% CA use) increasing from 8.6% (2020) to 29.6% (2035).

Conclusions: This analysis demonstrates divergent adoption patterns between IVL and CA, with IVL showing more rapid uptake. The findings highlight important implications for clinical practice, resource allocation, and health care policy.

预测经皮冠状动脉介入治疗中钙修饰策略采用的时间趋势和医院水平的变化。
背景:新型心血管介入技术的采用模式显著影响患者护理和卫生保健资源配置。本研究分析并预测血管内碎石术(IVL)与冠状动脉粥样硬化切除术(CA)的应用趋势。目的:研究到2035年各种钙改性策略的预测利用趋势。方法:利用来自多个美国注册中心(2009-2022)的数据,我们开发了蒙特卡罗模拟(n = 100,000次模拟迭代)来模拟采用趋势和医院水平的变化。运用Logistic增长模型预测到2035年的技术采用率。结果:IVL采用迅速,预计到2035年终末期率为32.41% (95% CI: 28.76% ~ 36.06%),平均年增长率为2.5% (95% CI: 2.1% ~ 2.9%)。到2035年,CA(旋转和轨道)的采用率预计将达到4.5%至5.5%(10%至90% CI: 3.8%至6.2%)。医院层面的分析显示,采用模式的差异越来越大,大容量中心(CA使用率为10%)从8.6%(2020年)增加到29.6%(2035年)。结论:该分析表明IVL和CA的采用模式不同,IVL的采用速度更快。研究结果强调了临床实践、资源分配和卫生保健政策的重要意义。
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来源期刊
JACC advances
JACC advances Cardiology and Cardiovascular Medicine
CiteScore
1.90
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0.00%
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