A propensity score matched valuation on feasibility of low frame rate fluoroscopy during primary percutaneous coronary intervention for patients with STEMI

2018 ◽  
Vol 35 (3) ◽  
pp. 393-399 ◽  
Author(s):  
Lin Fan ◽  
Yukun Luo ◽  
Zhaoyang Chen ◽  
Wei Cai ◽  
Xianfeng Dong ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Frame Rate ◽  
Percutaneous Coronary ◽  
Low Frame Rate

P3123Enoxaparin versus unfractionated heparin in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Graca Santos ◽  
R Ribeiro Carvalho ◽  
F Montenegro ◽  
C Ruivo ◽  
J Correia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Major Bleeding ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Group A ◽  
St Elevation ◽  
Group B

Abstract Background The use of intravenous enoxaparin (LBWH) in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) was upgraded in the latest European Guidelines to a class IIa recommendation. Purpose The authors aim to compare safety and prognostic impact of LMWH versus unfractionated heparin (UFH) use in STEMI patients undergoing primary PCI. Methods Retrospective study of 3875 STEMI patients who underwent pPCI between October 2010 and September 2017 and were included in a national multicenter registry. Group A consisted of patients managed only with LMWH, and Group B patients were treated with UFH regardless of eventual LMWH associated exposure. The groups were compared according to their demographic, clinical and laboratory characteristics. The primary endpoint (PE) results from a composite which included: procedural failure (pPCI failure or bailout use of GPIIb/IIIa inhibitors), in-hospital mortality, re-infarction or major bleeding (according to the registry criteria). The secondary endpoint (SE) included: in-hospital major bleeding, need for red blood cell transfusion, or haemoglobin drop ≥2g/dL. A 1:1 propensity score (PS) analysis was performed according to demographic variables, medical history and previous medication, physical examination, electrocardiogram characteristics and left ventricular function, matching 1558 of the 3875 patients for later comparison between groups. Results Overall, Group A included 1083 (27.9%) and Group B 2792 (72.1%) patients. The mean age was 63±14 years, and 33.5% of the cohort were female. Despite the baseline characteristics heterogeneity between groups, this phenomenon was not observed after PS matching. The PE was more frequent in Group A, without reaching statistical relevance (15.6% vs 13.3%, p=0.07). The SE was superior in Group A (34.4 vs 29.4%, p=0.01). According to the PS matching analysis, there were no differences beetween groups in terms of the PE (13.9% vs 12.0%, p=0.28), while the SE kept more frequent among Group A (34.9% vs 28.5%, p=0.02) [Figure]. Propensity score: group comparison Conclusion In this study based on a national multicentric registry of STEMI patients, the use of LMWH was not associated with better in-hospital prognosis in terms of major cardiovascular events and was related with higher rates of bleeding related events in the scenario of pPCI, compared to UFH. According to these results, further studies are required to support the widespread use of LMWH in this clinical scenario.

High-bolus dose tirofiban compared with abciximab in primary percutaneous coronary intervention: a propensity score-matched outcome study

2015 ◽  
Vol 10 (11) ◽  
pp. 1187-1194 ◽  
Author(s):  
David Austin ◽  
Daniel F. Mackay ◽  
Robert Morley ◽  
James Christie ◽  
Barry Hennigan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Primary Percutaneous Coronary Intervention ◽  
Bolus Dose ◽  
Coronary Intervention ◽  
Outcome Study ◽  
Percutaneous Coronary

P825Long-term clinical benefit of atorvastatin pretreatment before primary percutaneous coronary intervention in patients with STEMI: a multi-center propensity score-matched study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J G Yang ◽  
P Gao ◽  
T G Chen ◽  
X Li ◽  
H Y Xu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Composite Outcome ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Abstract Aims We aim to investigate the effect of single dose of statin pretreatment prior to primary Percutaneous Coronary Intervention (PCI) on long-term clinical outcomes in patients with ST-elevation Myocardial Infarction (STEMI). Methods Using data from China Acute myocardial Infarction (CAMI) registry, we compared the outcome in STEMI patients with vs without atorvastation pretreatment prior to primary PCI. The primary endpoint was the composite outcome of all-cause mortality, non-fatal MI or stroke events during follow-up. Propensity-score (PS) matching was used to assemble a cohort of patients with similar baseline characteristics. All patients were followed till 24 months since baseline. Results Of all 3772 patients who met our inclusion criteria at 108 hospitals in China, 3288 patients (1644 patients in each arm) were included in our PS-matched cohort. In the PS-match cohort, overall 144 (8.65%) and 113 (6.79%) patients in the control group and pretreatment group had the primary endpoint respectively (p=0.048). The estimated HRs were 0.78 (95% CI: 0.606–0.997, p=0.046) in the unadjusted model and 0.76 (95% CI: 0.596–0.984, p=0.032) in the adjusted model (Figure). The HRs were broadly similar for the pretreatment dosage of 40 mg or 80 mg (0.78 vs 0.77, p=0.75). The HRs were even stronger in patients with single-vessel only than multi-vessel coronary artery disease (0.31 vs 0.75, p=0.014). Conclusion Among Chinese patients with STEMI, atorvastatin pretreatment before primary PCI may have better long-term composite outcome of all-cause mortality, non-fatal MI, or stroke events. Acknowledgement/Funding CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)

scholarly journals Radiation Exposure Reduction and Patient Outcome by Using Very Low Frame Rate Fluoroscopy Protocol (3.8 + 7.5 fps) During Percutaneous Coronary Intervention

2021 ◽  
Vol 8 ◽  
Author(s):  
Ankush Gupta ◽  
Sanya Chhikara ◽  
Rajesh Vijayvergiya ◽  
Parag Barwad ◽  
Krishna Prasad ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Exposure ◽  
Retrospective Cohort ◽  
Coronary Intervention ◽  
Frame Rate ◽  
Cardiac Events ◽  
Air Kerma ◽  
Guide Catheter ◽  
Percutaneous Coronary ◽  
Low Frame Rate

Objectives: In this study, we intend to analyze the feasibility and efficacy of very low frame rate fluoroscopy (VLFF) protocol using a combination of 3.8 and 7.5 fps while performing Percutaneous Coronary Intervention (PCI).Methods: A retrospective cohort including 193 patients undergoing PCI under the VLFF protocol (Post-VLFF group) was compared with a retrospective cohort of 133 patients, who underwent PCI prior to implementation of VLFF protocol (Pre-VLFF group). In the Pre-VLFF group, all PCIs were performed using fluoroscopy frame rate of 15 fps. In the Post-VLFF group, 3.8 fps was used to guide catheter engagement, coronary lesion wiring, pre-and post-dilation, and 7.5 fps was used for lesion assessment and stent placement. Increasing use of fluoroscopic storage in place of cineangiography was also encouraged. Cine acquisition in both groups was performed at 15 fps. Primary endpoint was radiation exposure measured by Air Kerma. Secondary endpoints were procedure related outcomes and patient related outcomes (Major Adverse Cardiac Events including all-cause mortality, Target Lesion Failure, Myocardial Infarction, and Stroke).RESULTS: Post-VLFF group showed 74.7% reduction in Air Kerma as compared to Pre-VLFF group (433 ± 27 mGy vs. 1,714 ± 140 mGy; p < 0.0001), with no increase in the fluoroscopy time (15.38 ± 0.98 min Post-VLFF vs. 17.06 ± 1.29 min Pre-VLFF; p = 0.529) and contrast volume (116.5 ± 4.9 ml Post-VLFF vs. 116.7 ± 6 ml Pre-VLFF; p = 0.700). Both groups had comparable procedural success and complications rates as well as incidence of MACE.Conclusions: The very low frame rate fluoroscopy protocol is a feasible, effective, and safe method to significantly reduce the radiation exposure during PCI without any compromise on procedural and patient outcomes.

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