Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions最新文献

{"title":"Balloon Shaft-Assisted Guide Catheter Exchange Without PTCA Wire Removal.","authors":"Kapil Rajendran, Vinayakumar Desabandhu","doi":"10.1002/ccd.70216","DOIUrl":"https://doi.org/10.1002/ccd.70216","url":null,"abstract":"<p><p>We describe a balloon shaft-assisted technique for guide catheter exchange without removing the in-situ PTCA wire. In a complex LCX in-stent restenosis case with poor guide support, a 6 Fr EBU catheter was successfully advanced over the metallic shaft of a monorail balloon tracked on a 0.014″ PTCA wire. Bench testing confirmed the shaft's ability to mimic a stiff 0.035″ wire, providing adequate support for safe catheter exchange. This technique eliminates the need for anchoring or specialized wires and offers a practical, resource-efficient solution for guide exchange, particularly in settings with limited device availability.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Calcium Fracture After Balloon Angioplasty in Patients With Complex Calcified Coronary Plaque ~The Results of the OCT-CALC Registry~.","authors":"Nobuhiko Maejima, Tsutomu Endo, Takashi Ashikaga, Taishi Yonetsu, Kazuhiro Ashida, Hiroshi Ohira, Takahiko Kiyooka, Tomohiko Shigemasa, Gaku Nakazawa, Yuji Ikari, Akihiro Hata, Tetsuya Tobaru, Itaru Takamisawa, Teruyasu Sugano, Ichiro Michishita, Kouji Yamamoto, Toshiro Shinke, Ken Kozuma, Yasuhiro Honda, Kiyoshi Hibi","doi":"10.1002/ccd.70189","DOIUrl":"https://doi.org/10.1002/ccd.70189","url":null,"abstract":"<p><strong>Background: </strong>Target lesion calcification is known to influence the percutaneous coronary intervention (PCI) outcomes. This study aimed to assess the impact of calcium fractures after balloon angioplasty on the PCI results as well as the long-term clinical outcomes.</p><p><strong>Methods: </strong>We formed a prospective, multicenter registry that enrolled 268 patients who underwent PCI to lesions with moderate to severe calcification. Balloon dilatation and subsequent drug eluting stent implantation were performed with optical coherence tomography (OCT) guidance in every case. Serial OCT images just before and after balloon angioplasty, and after stent implantation were analyzed at 1-mm intervals by an independent core laboratory. The primary endpoint was the relationship between calcium fracture after balloon angioplasty and stent expansion. The secondary endpoint was target vessel failure (TVF) at 1 year, defined as a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization.</p><p><strong>Results: </strong>A total of 242 patients were analyzed. Of these, OCT analysis was performed in 147 patients with a complete OCT data set. Calcium fractures were observed in 28 patients (19%) at the minimal lumen area site. The percent stent expansion was greater in lesions with calcium fracture than those without (99 ± 26% vs. 91 ± 18%, p = 0.039). In 229 patients who underwent clinical follow-up at 1 year, TVF occurred in 23 patients (10.0%).</p><p><strong>Conclusion: </strong>The OCT-guided PCI strategy demonstrated acceptable acute and 1-year clinical outcomes. The presence of calcium fractures after balloon angioplasty may have a potential impact on acute results after DES implantation in calcified lesions.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional Value of Optical Coherence Tomography-Derived Virtual Flow Reserve for Percutaneous Coronary Intervention Guidance.","authors":"Andrea Marrone, Andrea Erriquez, Filippo Maria Verardi, Iginio Colaiori, Marta Cocco, Serena Caglioni, Carlo Tumscitz, Carlo Penzo, Federico Marchini, Jennifer Meinen, JoAnna McNutt, Jorn Op den Buijs, Wei Che Chiu, Francesco Versaci, Gianluca Campo, Simone Biscaglia","doi":"10.1002/ccd.70207","DOIUrl":"https://doi.org/10.1002/ccd.70207","url":null,"abstract":"<p><strong>Background: </strong>The combination of imaging and physiology could provide the best guidance for complex and high-risk interventional procedures (CHIP).</p><p><strong>Aims: </strong>The objective of the present study is to evaluate the difference in percutaneous coronary intervention (PCI) planning in CHIP patients between angiography, angiography-derived fractional flow reserve (FFR), and the combination of imaging and physiology by means of optical coherence tomography plus virtual flow reserve (OCT-VFR). Secondary objectives were to evaluate disease pattern, virtual stent length, and RVD according to the different plans.</p><p><strong>Methods: </strong>Among patients included in the AQVA-I and II trials, we selected those receiving OCT (n = 114). Physiology reconstruction based on OCT traces was obtained in 97 patients. One operator, blinded to the actual procedural plan and to post-PCI result, planned the procedure according to angiography, angiography-derived FFR, OCT, and OCT-VFR.</p><p><strong>Results: </strong>OCT-VFR plan was different compared to angiography and angiography-derived FFR plans in 48% and 30% of the cases, respectively. OCT-VFR plan was also different from OCT plans in 25% of the cases, mainly because of a different disease pattern leading to shorter treatment. Pattern of disease was more frequently focal in the angiography-derived FFR plan if compared to OCT-VFR plan (p < 0.01). Stent length was different across different plans (p for trend < 0.001) with angiography-derived FFR with the shortest and OCT with the longest, respectively.</p><p><strong>Conclusions: </strong>OCT-VFR provided a different PCI plan than both angiography and angiography-derived FFR in more than one-third of the cases. If compared to OCT alone, the OCT-VFR plan was significantly shorter in terms of stent length.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05658952, NCT04664140.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual Mitral Regurgitation Outweighs Mean Pressure Gradient in Predicting Long-Term Survival After Transcatheter Edge-to-Edge Repair Across Mitral Regurgitation Etiologies.","authors":"Dennis Rottländer, Jörg Hausleiter, Thomas Schmitz, Alexander Bufe, Melchior Seyfarth, Harald Beucher, Taoufik Ouarrak, Steffen Schneider, Peter Boekstegers","doi":"10.1002/ccd.70215","DOIUrl":"https://doi.org/10.1002/ccd.70215","url":null,"abstract":"<p><strong>Background: </strong>The influence of elevated mitral mean pressure gradient (MPG) following transcatheter edge-to-edge repair (TEER) on survival across mitral regurgitation (MR) etiologies is controversial.</p><p><strong>Aims: </strong>To evaluate the impact of MPG and residual MR on survival following TEER.</p><p><strong>Methods: </strong>In the MITRA-PRO registry survival was assessed three years after mitral TEER for patients with functional (FMR) or degenerative mitral regurgitation (DMR) and MPG < 5 mmHg or ≥ 5 mmHg in the presence or absence of relevant residual MR.</p><p><strong>Results: </strong>In the MPG < 5 mmHg group 720 patients with FMR were included (57.4%), while 125 patients with MPG ≥ 5 mmHg had FMR (54.1%). 358 patients were identified with MPG < 5 mmHg and 70 patients with MPG ≥ 5 mmHg (16.4%) post TEER in DMR. Only 11 patients had MPG ≥ 7 mmHg. In both FMR and DMR 3-year mortality was not significantly higher in the MPG ≥ 5 mmHg group compared to MPG < 5 mmHg. An analysis with MPG groups (<3; 3; 4; 5; >5 mmHg) demonstrated no increment in 3-year mortality over MPG groups for FMR and DMR. For both groups, residual MR was the main predictor of 3-year mortality, while elevated MPG did not negatively affect survival. Independent of MR entity, the lowest mortality was found without relevant residual MR. In atrial functional MR 3-year mortality was also comparable between MPG < 5 and MPG ≥ 5 mmHg.</p><p><strong>Conclusions: </strong>An increased MPG of 5-6 mmHg in patients without relevant residual MR did not lead to an increased mortality rate across all MR entities, demonstrating the pivotal role of residual MR for survival following TEER.</p><p><strong>Trial registration: </strong>DRKS00012288.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Survival After Post-Myocardial Infarction Ventricular Septal Defect (VSD) Closure, Multiple Percutaneous Coronary Interventions and Edge-to-Edge Repair.","authors":"Heidi Turner, Mandie Townsend, Julian Strange, Mark Turner","doi":"10.1002/ccd.70197","DOIUrl":"https://doi.org/10.1002/ccd.70197","url":null,"abstract":"<p><p>This reports a case of a female aged 65 who presented in cardiogenic shock secondary to an inferior ST-elevation myocardial infarction and was diagnosed with a post-infarction ventricular septal defect (VSD) and was also found to have severe mitral valve regurgitation. She was not surgically operable, so underwent percutaneous VSD repair. Over the next 12 years she underwent multiple coronary stent procedures and presented with episodes of decompensated heart failure requiring edge-to-edge mitral valve repair. Despite having a low chance of survival and undergoing multiple high-risk procedures, she has survived over 12 years, with symptomaticimprovement. This demonstrates that even if patients present in what seems to be a futile clinical situation with post-infarction VSD, if they can survive the acute peri-infarct period they can survive for many years. Having survived the myocardial infarction, they can benefit from future interventions, as was the case for this patient who benefitted from edge-to-edge repair of the mitral valve to further improve her symptoms and prognosis.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Approach to Treat Coronary Chronic Total Occlusion: Balloon-Assisted Revascularization-A Retrospective Study.","authors":"Yanzhuo Ma, Xinxing Song, Lina Tang, Lingfeng Kong, Gang Wang, Xiaoye Wang, Yuying Zhao, Qiuwang Zhang, Leisheng Ru","doi":"10.1002/ccd.70214","DOIUrl":"https://doi.org/10.1002/ccd.70214","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains a significant challenge and new techniques are needed for rapid and safe CTO recanalization.</p><p><strong>Aims: </strong>To explore a novel balloon-assisted revascularization technique (BART) for successful management of CTO.</p><p><strong>Methods: </strong>Patients who underwent CTO recanalization using BART between January 2020 and June 2022 were included in this study. The baseline clinical data, CTO vessel characteristics, and technical details were retrospectively analyzed. The procedure began with antegrade guidewire crossing of the CTO lesion. If contralateral angiography demonstrated the guidewire entering the subintimal space, a balloon was advanced along the guidewire and inflated. The inflated balloon served as a mechanical barrier to block antegrade blood flow to prevent hematoma formation, meanwhile providing back-up support facilitating the manipulation of a second guidewire for CTO penetration and final recanalization.</p><p><strong>Results: </strong>A total of 32 consecutive patients who underwent the procedure were included in this study. The median J-CTO score was 2.5 with 26 patients (81.3%) having a J-CTO score ≥ 2. The right coronary artery was the most commonly affected vessel; 12 patients (37.5%) had BART as the first choice while 20 (62.5%) as an alternative after failure with other techniques. Technique and procedure success was achieved in 28 cases (87.5%). Procedure-associated complications included cardiac tamponade (n = 1), femoral artery hematoma (n = 1), and subintimal hematoma (n = 1). There were no major cardiac adverse events.</p><p><strong>Conclusion: </strong>BART is an effective and safe recanalization method for CTOs that are difficult to treat with other techniques, offering improved outcomes.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes Post-Transcatheter Aortic Valve Replacement in Patients With Hypertrophic Obstructive Cardiomyopathy.","authors":"Muhammad Usman Almani, Vibhor Ahluwalia, Muhammad Yousuf, Jafar Alzubi, Mohammad Hamza, Raphael Bonita, Christian Witzke","doi":"10.1002/ccd.70201","DOIUrl":"https://doi.org/10.1002/ccd.70201","url":null,"abstract":"<p><strong>Background: </strong>Patients with hypertrophic obstructive cardiomyopathy (HOCM) were excluded from all major trials for transcatheter aortic valve replacement (TAVR). \"Suicide left ventricle\" occurring after TAVR is postulated to occur as a result of chronic pressure overload from fixed obstruction that is acutely relieved after the valve deployment resulting in worsening left ventricular outflow tract obstruction.</p><p><strong>Aims: </strong>The aim of this study was to determine the clinical and readmission outcomes in HOCM patients undergoing TAVR.</p><p><strong>Methods: </strong>Data was extracted from the National Inpatient and National Readmission 2016-2020 Databases. We performed multivariable Logistic regression analysis to determine the odds of in-hospital mortality and other relevant clinical outcomes in patients undergoing TAVR with and without comorbid HOCM. Multivariable Cox regression analysis was used to assess 30-day hospital readmission in HOCM patients undergoing TAVR.</p><p><strong>Results: </strong>We identified 296,670 patients who underwent TAVR, of whom 534 (0.2%) had comorbid HOCM. The patients undergoing TAVR with comorbid HOCM had more than threefold higher risk of in-hospital mortality (adjusted odds ratio: 3.47, 95% CI 1.37-8.81, p = 0.009) when compared to patients without HOCM. Additionally, patients undergoing TAVR with comorbid HOCM had a higher risk of atrioventricular blocks, cardiogenic shock, acute kidney injury, and the need for intubation. There was no difference in readmission outcomes post-TAVR among patients with and without HOCM.</p><p><strong>Conclusion: </strong>Our analysis of a large, real-world cohort of patients undergoing TAVR showed that patients with HOCM have a significantly higher risk of in-hospital mortality and procedural complications when compared to patients without HOCM.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Diabetes Mellitus on Clinical Outcomes After Transcatheter Aortic Valve Implantation: An Updated Systematic Review and Meta-Analysis.","authors":"Roberta Andreucci Pereira Gomes, Ricardo Fonseca Oliveira Suruagy Motta, Evandro Martins Filho, Lidia Cheidde, Karlos Daniell Araújo Dos Santos, João Victor Androlage Assumpção, Lorenzo Furlan Anselmi, Altair Pereira de Melo Neto, Alexandre Negrao Pantaleao, Khaled M Harmouch, Kalgi Modi","doi":"10.1002/ccd.70190","DOIUrl":"https://doi.org/10.1002/ccd.70190","url":null,"abstract":"<p><p>Transcatheter Aortic Valve Implantation (TAVI) or Replacement (TARV) is a widely established treatment for symptomatic severe aortic stenosis (AS) in patients with high or intermediate surgical risk. Diabetes mellitus (DM) is prevalent in TAVR patients and is associated with an increased risk of cardiovascular events, which may elevate procedural risks. A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Web of Science, and Cochrane databases were searched. A random-effects model was applied, with 95% confidence intervals (CIs) and a 5% significance level. Statistical analyses were performed using RStudio version 4.4.1. Twelve studies with 214,444 patients were included, comprising 74,294 diabetic and 140,150 nondiabetic individuals. The analysis revealed no significant differences in all-cause mortality, procedure mortality, 30-day mortality, or complications such as bleeding, myocardial infarction, and major complications. However, 1-year mortality was significantly higher in the diabetic group (RR: 1.51, 95% CI: 1.08-2.13). Diabetic patients were at higher risk for renal injury (RR: 1.46, 95% CI: 1.40-1.51) and lower risk of stroke (RR: 0.91, 95% CI: 0.83-0.99). The length of hospital stay and other major complications showed no significant differences. There was an increased risk of 1-year mortality and renal injury in diabetic patients undergoing TAVI compared to non-diabetics. Surprisingly, the risk for developing stroke in the diabetic group was significantly lower. In any case, the study emphasizes the need for tighter DM control to decrease the risk of such complications in the future.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Comparison of Urgent Transcatheter Aortic Valve Implantation and Balloon Aortic Valvuloplasty: A Systematic Review and Meta-Analysis.","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Konstantinos Aznaouridis, Guillaume Bonnet, Eirini Beneki, Panagiotis Theofilis, Aristides Plaites, Alexios Antonopoulos, Christina Chrysohoou, Konstantinos Tsioufis","doi":"10.1002/ccd.70208","DOIUrl":"https://doi.org/10.1002/ccd.70208","url":null,"abstract":"<p><strong>Objective: </strong>Aortic stenosis (AS) may complicate cardiogenic shock (CS) or acute decompensated heart failure (ADHF) in a small but significant number of patients. In such cases, urgent treatment is necessary to prevent mortality and adverse outcomes. Transcatheter aortic valve implantation (TAVI) and balloon aortic valvuloplasty (BAV) represent the main treatment options, however, limited studies have compared them directly. Therefore, this systematic review and meta-analysis aims to synthesize available studies directly comparing urgent TAVI and BAV, in respect to reported outcomes.</p><p><strong>Methods: </strong>We systematically searched MEDLINE/PubMed, Scopus and Web of Science for studies comparing outcomes in patients with CS or ADHF undergoing urgent TAVI or BAV. Followingly, a meta-analysis of all included studies was performed.</p><p><strong>Results: </strong>A total of six studies, including 21,020 patients (10,597 patients undergoing TAVI and 10,423 patients undergoing BAV) were analyzed. Regarding in-hospital mortality, it was found to be significantly lower in patients undergoing urgent TAVI, compared to BAV (risk ratio [RR]: 0.53; 95% confidence interval (CI): 0.32-0.87]. Moreover, urgent TAVI was also associated with significantly lower all-cause mortality at 30-days follow up (RR 0.51, 95% CI: 0.31-0.84).</p><p><strong>Conclusion: </strong>In this meta-analysis of observational, retrospective studies including patients undergoing urgent transcatheter interventions for acute AS, TAVI is associated with significantly reduced in-hospital and 30-days mortality, in comparison to BAV. More larger studies, reporting extended follow-up and adverse events' rates, are needed to safely conclude regarding the benefit of urgent interventions in the acute care.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention.","authors":"Sant Kumar, Kathleen E Kearney, Christine J Chung, David Elison, Zachary L Steinberg, William L Lombardi, James M McCabe, Lorenzo Azzalini","doi":"10.1002/ccd.70219","DOIUrl":"https://doi.org/10.1002/ccd.70219","url":null,"abstract":"<p><strong>Background: </strong>Frailty has a negative impact on cardiovascular care and resource utilization.</p><p><strong>Aims: </strong>We aimed to assess the impact of frailty on percutaneous coronary intervention (PCI) outcomes in a large cohort of patients undergoing PCI at a specialized referral center.</p><p><strong>Methods: </strong>This retrospective study included all patients undergoing PCI at our institution between 2018 and 2024. Patients were stratified by frailty using the clinical frailty scale (CFS). The primary outcome was in-hospital and 1-year all-cause mortality. Adjusted analyses were conducted with multivariable logistic regression and inverse probability of treatment weighting (IPTW) to evaluate associations between frailty and outcomes.</p><p><strong>Results: </strong>A total of 5297 patients were included, with 2210 (41.7%) classified as non-frail (CFS 1-3), 1801 (34.0%) as vulnerable (CFS 4), and 1286 (24.3%) as frail (CFS 5-9). Frail patients had a higher mean age, prevalence of women, and cardiovascular comorbidities. They also exhibited a higher procedural risk profile. In adjusted analyses (IPTW), in-hospital mortality was 0.3% in non-frail versus 0.4% in vulnerable versus 2.1% in frail patients (p < 0.001). The incidence of stroke and acute kidney injury was also highest in frail patients. At 1-year, frail patients had higher rates of all-cause mortality (p < 0.001), cardiovascular mortality (p = 0.041), and stroke (p < 0.001), compared to non-frail patients.</p><p><strong>Conclusion: </strong>Frailty is an independent predictor of in-hospital mortality and long-term adverse events in PCI patients, even after controlling for clinical and procedural characteristics, highlighting the need for routine frailty assessment to improve risk stratification and guide management.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}