Survival of Patients Undergoing Rescue Percutaneous Coronary Intervention

Burjonroppa, Sukesh; Varosy, Paul D.; Rao, Sunil V.; Ou, Fang Shu; Roe, Matthew T.; Peterson, Eric D.; Singh, Mandeep; Shunk, Kendrick A.

doi:10.1016/j.jcin.2010.09.020

Cited by 12 publications

(5 citation statements)

References 46 publications

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“…Age has been established as a major determinant of cardiovascular risk in all prediction models, 9 predicting an increased risk of subclinical cardiovascular disease, 28 symptomatic CAD, 29 and acute coronary syndromes as well poor prognostic outcomes following surgical and percutaneous interventions. 6,30,31 Our study results further corroborate the existing literature by demonstrating poorer outcomes with increasing age in individuals undergoing LMCA revascularization. These observations underscore the importance of cautiously addressing the acute coronary care in elderly individuals and avoiding any gaps in the delivery of treatment.…”

Section: Discussionsupporting

confidence: 88%

“…Race was self-identified by the study subject. End-points recorded included: (1) recurrent myocardial infarction (MI) documented during any clinical encounter after index cardiac catheterization, and (2) all cause mortality, which was determined from the Social Security Death Index (SSDI) until Septem-ber 30,2009. Prior studies have shown SSDI to be an accurate measure of death as an outcome.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Racial Disparities in Left Main Stenting: Insights from a Real World Inner City Population

Mohamad

Panaich

Alani

et al. 2013

J Interven Cardiology

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Racial Disparities in Left Main Stenting: Insights from a Real World Inner City Population

Mohamad

Panaich

Alani

et al. 2013

J Interven Cardiology

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“…Rescue PCI remains an infrequent procedure in various data registry analysis because many clinicians do not assess the success of reperfusion in patients with STEMI, who receive thrombolytic analysis, and only a minority are candidates for rescue PCI due to failed fibrinolysis [13]. As shown in our survey, most CAD patients requiring percutaneous interventions underwent primary PCI; only 17% of the study patients had rescue PCI because of thrombolysis failure.…”

Section: Discussionmentioning

confidence: 78%

In-hospital and late outcome of rescue versus primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Vakili

Sadeghi

Borjian

et al. 2016

ijcp

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Introduction: Despite high technical success of rescue Percutaneous Coronary Intervention (PCI) and also its significant impact on left ventricular function, the therapeutic outcome of this PCI technique in comparison with primary PCI for coronary reperfusion has remained uncertain. The present study aimed to conduct a comparative analysis of early and long-term results of patients with ST-Elevation Myocardial Infarction (STEMI), who had undergone primary or rescue PCI. Methods: One hundred and twenty-nine consecutive patients with the diagnosis of STEMI, who underwent primary PCI (n = 107) or rescue PCI (n = 22) from April 2012 to September 2013 were retrospectively included. In addition to early assessment of procedural consequences, the patients were followed-up to assess and compare long-term mortality and major adverse cardiovascular events. Results: Comparing in-hospital consequences of the two rescue PCI and primary PCI procedures showed no significant differences in in-hospital mortality (9.5% vs. 3.7%, P = 0.255), total hospital stay (6.32 ± 2.24 days vs. 6.61 ± 3.43 days, P = 0.720) and also in early procedural complications. Long-term death was found only in 1.9% of patients in the primary group and none of the patients in the rescue group (P = 0.999). There was also no difference in the prevalence of late stent thrombosis between the two groups. However, the in-hospital Left Ventricular Ejection Fraction (LVEF) was lower in the rescue PCI group vs. primary PCI group (36.82 ± 11.19 vs. 43.48 ± 9.14, P = 0.014), but after six months, LVEF was similar between the two groups (41.05 ± 9.57 vs. 44.29 ± 10.35, P = 0.082). Conclusions: Our study showed no difference in early and late procedural outcome between the primary and rescue PCI techniques in STEMI patients, but LVEF had better improvement in the rescue PCI group.

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“…While previous risk prediction algorithms have been derived and validated for patients' risk of mortality and major procedural complications both during and following PCI , few reports to date have specifically examined factors associated with 30‐day readmission following PCI. Indeed, previous studies have found that 30‐day readmission is associated with several sociodemographic (e.g., female sex, older age), clinical (e.g., diabetes mellitus, current congestive heart failure, acute myocardial infarction, peripheral arterial disease, previous PCI, complications related to the PCI, length of stay), and angiographic (e.g., depressed ejection fraction, higher number and fewer significant lesions treated, emergent or urgent PCI status) risk factors .…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a simple risk score to predict 30‐day readmission after percutaneous coronary intervention in a cohort of medicare patients

Minges

Herrin

Fiorilli

et al. 2016

Cathet Cardio Intervent

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Objectives To develop a risk model that can be used to identify PCI patients at higher risk of readmission who may benefit from additional resources at the time of discharge. Background A high proportion of patients undergoing PCI are readmitted within 30 days of discharge. Methods The sample comprised patients aged ≥65 years who underwent PCI at a CathPCI Registry®-participating hospital and could be linked with 100% Medicare fee-for-service claims between 01/2007-12/2009. The sample (n=388,078) was randomly divided into risk score development (n=193,899) and validation (n=194,179) cohorts. We did not count as readmissions those associated with staged revascularization procedures. Multivariable logistic regression models using stepwise selection models were estimated to identify variables independently associated with all-cause 30-day readmission. Results The mean 30-day readmission rates for the development (11.36%) and validation (11.35%) cohorts were similar. In total, 19 variables were significantly associated with risk of 30-day readmission (p<0.05), and model c-statistics were similar in the development (0.67) and validation (0.66) cohorts. The simple risk score based on 14 variables identified patients at high and low risk of readmission. Patients with a score of ≥13 (15.4% of sample) had more than an 18.5% risk of readmission, while patients with a score ≤6 (41.9% of sample) had less than an 8% risk of readmission. Conclusion Among PCI patients, risk of readmission can be estimated using clinical factors present at the time of the procedure. This risk score may guide clinical decision-making and resource allocation for PCI patients at the time of hospital discharge.

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Survival of Patients Undergoing Rescue Percutaneous Coronary Intervention

Abstract: In-hospital mortality risk among individuals undergoing rescue PCI varies from minimal to extreme and can be easily calculated using the NCDR-RESCUE score. This information can be of value in counseling patients, families, and referring caregivers.

Cited by 12 publications

References 46 publications

Racial Disparities in Left Main Stenting: Insights from a Real World Inner City Population

Racial Disparities in Left Main Stenting: Insights from a Real World Inner City Population

In-hospital and late outcome of rescue versus primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Development and validation of a simple risk score to predict 30‐day readmission after percutaneous coronary intervention in a cohort of medicare patients

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