Feasibility of rotational atherectomy in patients with acute coronary syndrome : favorable in-hospital outcomes and clinical importance of complexed coronary atherosclerosis
© 2023. Springer Nature Japan KK, part of Springer Nature..
The feasibility of rotational atherectomy (RA) during percutaneous coronary intervention (PCI) in patients who present with acute coronary syndrome (ACS) remains fully unsettled. We retrospectively evaluated 198 consecutive patients who underwent RA during PCI from 2009 to 2020. All patients underwent intracoronary imaging (intravascular ultrasound 96.5%, optical coherence tomography 9.1%, both 5.6%) during PCI. Patients who underwent RA during PCI were divided into two groups: ACS (n = 49; unstable angina pectoris, n = 27; non-ST-elevation myocardial infarction, n = 18, and ST-elevation myocardial infarction, n = 4) and chronic coronary syndrome (CCS) (n = 149). The RA procedural success rate was comparable between in the ACS and CCS groups (93.9 vs. 89.9%, P = 0.41). No significant differences were observed in procedural complications and in-hospital death between the groups. The incidence of major adverse cardiovascular event (MACE) after 2 years was significantly higher in ACS group compared with CCS group (38.7 vs. 17.4%, log-rank P = 0.002). Multivariable Cox regression analysis identified SYNTAX score or CABG SYNTAX score > 22 (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.40-5.06, P = 0.002) and mechanical circulatory support during the procedure (HR 2.61, 95% CI 1.21-5.59, P = 0.013) as predictors of MACE at 2 years, but not ACS on index admission (HR 1.58, 95% CI 0.84-2.99, P = 0.151). RA procedure is feasible as a bail-out strategy for ACS lesions. However, more complexed coronary atherosclerosis and mechanical circulatory support during RA procedure, but no ACS lesions were associated with worse mid-term clinical outcomes.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Heart and vessels - 38(2023), 10 vom: 18. Okt., Seite 1193-1204 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Yoneda, Shuichi [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute coronary syndrome |
|---|
| Anmerkungen: |
Date Completed 31.08.2023 Date Revised 31.08.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00380-023-02272-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM357050703 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM357050703 | ||
| 003 | DE-627 | ||
| 005 | 20231226071746.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00380-023-02272-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1190.xml |
| 035 | |a (DE-627)NLM357050703 | ||
| 035 | |a (NLM)37202532 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yoneda, Shuichi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Feasibility of rotational atherectomy in patients with acute coronary syndrome |b favorable in-hospital outcomes and clinical importance of complexed coronary atherosclerosis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 31.08.2023 | ||
| 500 | |a Date Revised 31.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. Springer Nature Japan KK, part of Springer Nature. | ||
| 520 | |a The feasibility of rotational atherectomy (RA) during percutaneous coronary intervention (PCI) in patients who present with acute coronary syndrome (ACS) remains fully unsettled. We retrospectively evaluated 198 consecutive patients who underwent RA during PCI from 2009 to 2020. All patients underwent intracoronary imaging (intravascular ultrasound 96.5%, optical coherence tomography 9.1%, both 5.6%) during PCI. Patients who underwent RA during PCI were divided into two groups: ACS (n = 49; unstable angina pectoris, n = 27; non-ST-elevation myocardial infarction, n = 18, and ST-elevation myocardial infarction, n = 4) and chronic coronary syndrome (CCS) (n = 149). The RA procedural success rate was comparable between in the ACS and CCS groups (93.9 vs. 89.9%, P = 0.41). No significant differences were observed in procedural complications and in-hospital death between the groups. The incidence of major adverse cardiovascular event (MACE) after 2 years was significantly higher in ACS group compared with CCS group (38.7 vs. 17.4%, log-rank P = 0.002). Multivariable Cox regression analysis identified SYNTAX score or CABG SYNTAX score > 22 (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.40-5.06, P = 0.002) and mechanical circulatory support during the procedure (HR 2.61, 95% CI 1.21-5.59, P = 0.013) as predictors of MACE at 2 years, but not ACS on index admission (HR 1.58, 95% CI 0.84-2.99, P = 0.151). RA procedure is feasible as a bail-out strategy for ACS lesions. However, more complexed coronary atherosclerosis and mechanical circulatory support during RA procedure, but no ACS lesions were associated with worse mid-term clinical outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute coronary syndrome | |
| 650 | 4 | |a Coronary atherosclerosis | |
| 650 | 4 | |a Percutaneous coronary intervention | |
| 650 | 4 | |a Rotational atherectomy | |
| 700 | 1 | |a Asaumi, Yasuhide |e verfasserin |4 aut | |
| 700 | 1 | |a Murai, Kota |e verfasserin |4 aut | |
| 700 | 1 | |a Iwai, Takamasa |e verfasserin |4 aut | |
| 700 | 1 | |a Matama, Hideo |e verfasserin |4 aut | |
| 700 | 1 | |a Sawada, Kenichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Miura, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Honda, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Fujino, Masashi |e verfasserin |4 aut | |
| 700 | 1 | |a Takagi, Kensuke |e verfasserin |4 aut | |
| 700 | 1 | |a Otsuka, Fumiyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kataoka, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Nishimura, Kunihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Noguchi, Teruo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Heart and vessels |d 1993 |g 38(2023), 10 vom: 18. Okt., Seite 1193-1204 |w (DE-627)NLM012974587 |x 1615-2573 |7 nnns |
| 773 | 1 | 8 | |g volume:38 |g year:2023 |g number:10 |g day:18 |g month:10 |g pages:1193-1204 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00380-023-02272-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 38 |j 2023 |e 10 |b 18 |c 10 |h 1193-1204 | ||