Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions

被引:45
作者
Hannan, Edward L. [1 ]
Samadashvili, Zaza [1 ]
Walford, Gary [2 ]
Holmes, David R. [3 ]
Jacobs, Alice [4 ]
Sharma, Samin [5 ]
Katz, Stanley [6 ]
King, Spencer B., III [7 ]
机构
[1] SUNY Albany, Albany, NY USA
[2] St Josephs Hosp, Syracuse, NY USA
[3] Mayo Clin, Rochester, MN USA
[4] Boston Med Ctr, Boston, MA USA
[5] Mt Sinai Med Ctr, New York, NY 10029 USA
[6] N Shore LIJ Hlth Syst, Manhasset, NY USA
[7] St Josephs Hosp, Atlanta, GA USA
关键词
ad hoc PCI; non-ad hoc PCI; long-term mortality; subsequent revascularization; in-hospital mortality; DIAGNOSTIC CATHETERIZATION; PROPENSITY SCORE; ANGIOPLASTY; SAFETY; ANGIOGRAPHY; EFFICACY; REGISTRY;
D O I
10.1016/j.jcin.2009.01.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives Our aim was to compare longer-term outcomes for ad hoc percutaneous coronary intervention (PCI) and non-ad hoc PCI. Background Ad hoc PCIs, whereby PCI is performed immediately after cardiac catheterization, has become the most common way of performing PCI. However, no studies have compared longer-term outcomes for ad hoc and non-ad hoc PCIs. Methods A total of 46,565 New York State patients who underwent PCI in nonfederal New York State hospitals between January 1, 2003 and June 30, 2005 were followed through December 31, 2005, and in-hospital and longer-term outcomes were compared for ad hoc and non,ad hoc PCI patients after adjusting for differences in pre-procedural risk factors. Results There was no difference in risk-adjusted in-hospital mortality (adjusted ad hoc/non-ad hoc odds ratio: 0.82, 95% confidence interval [Cl]: 0.55 to 1.22). Ad hoc PCI patients had significantly lower 36-month mortality (adjusted hazard ratio [HR]: 0.76, 95% CI: 0.69 to 0.85, p < 0.0001). Ad hoc PCI patients had significantly higher 36-month subsequent revascularization (adjusted HR: 1.11, 95% CI: 1.01 to 1.21, p = 0.03), but after excluding subsequent PC's that occurred within 30 days of the index PCI in another vessel, the difference was no longer significant (adjusted HR: 1.03, 95% CI: 0.95 to 1.12, p = 0.43). Conclusions On average, lower-risk patients undergo ad hoc PCI, and after risk-adjustment for differences in patient mix, ad hoc PCI patients have lower 3-year mortality rates. (J Am Coll Cardiol Intv 2009;2:350-6) (C) 2009 by the American College of Cardiology Foundation
引用
收藏
页码:350 / 356
页数:7
相关论文
共 15 条
[1]  
[Anonymous], SURVIVAL ANAL USING
[2]  
[Anonymous], HEART DIS STROK STAT
[3]  
Blankenship JC, 2000, CATHETER CARDIO INTE, V49, P130, DOI 10.1002/(SICI)1522-726X(200002)49:2<130::AID-CCD3>3.0.CO
[4]  
2-T
[5]  
Eagle Kim A, 2004, J Am Coll Cardiol, V44, pe213
[6]   Outcomes following immediate (Ad hoc) versus staged percutaneous coronary interventions (Report from the 2000 to 2001 New York State Angioplasty Registry) [J].
Feldman, Dmitriy N. ;
Minutello, Robert m ;
Gade, Christopher L. ;
Wong, S. Chiu .
AMERICAN JOURNAL OF CARDIOLOGY, 2007, 99 (04) :446-449
[7]   Impact of cardiac catheterization-percutaneous coronary intervention timing on inhospital mortality [J].
Goldstein, CL ;
Racz, M ;
Hannan, EL .
AMERICAN HEART JOURNAL, 2002, 144 (04) :561-567
[8]   Ad hoc percutaneous coronary interventions in patients with stable coronary artery disease - A study of prevalence, safety, and variation in use from the American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR) [J].
Krone, Ronald J. ;
Shaw, Richard E. ;
Klein, Lloyd W. ;
Blankenship, James C. ;
Weintraub, William S. .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2006, 68 (05) :696-703
[9]   SAFETY AND COST-EFFECTIVENESS OF COMBINED CORONARY ANGIOGRAPHY AND ANGIOPLASTY [J].
OKEEFE, JH ;
GERNON, C ;
MCCALLISTER, BD ;
LIGON, RW ;
HARTZLER, GO .
AMERICAN HEART JOURNAL, 1991, 122 (01) :50-54
[10]   SAFETY AND EFFICACY OF PERCUTANEOUS TRANS-LUMINAL CORONARY ANGIOPLASTY PERFORMED AT TIME OF DIAGNOSTIC CATHETERIZATION COMPARED WITH THAT PERFORMED AT OTHER TIMES [J].
OKEEFE, JH ;
REEDER, GS ;
MILLER, GA ;
BAILEY, KR ;
HOLMES, DR .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (01) :27-29