Trends and outcomes of utilization of thrombectomy during primary percutaneous coronary intervention

Authors

Michael Megaly
Ramy Sedhom
Ayman Elbadawi
Marwan Saad
Mohamed Omer
Emmanouil S. Brilakis
Mir B. Basir, Henry Ford HealthFollow
Farouc A. Jaffer
Mohammad Zaidan, Henry Ford HealthFollow
Mohammad Alqarqaz, Henry Ford HealthFollow
Khaldoon Alaswad, Henry Ford HealthFollow

Recommended Citation

Megaly M, Sedhom R, Elbadawi A, Saad M, Omer M, Brilakis ES, Basir MB, Jaffer FA, Zaidan M, Alqarqaz M, and Alaswad K. Trends and outcomes of utilization of thrombectomy during primary percutaneous coronary intervention. Cardiovasc Revasc Med 2021.

Document Type

Article

Publication Date

5-27-2021

Publication Title

Cardiovasc Revasc Med

Abstract

BACKGROUND: To describe the national trends and outcomes of contemporary thrombectomy use for primary percutaneous coronary intervention (PCI) from 2016 to 2018.

METHODS: We queried the Nationwide Readmission Database (NRD) from January 2016 to December 2018 to identify patients who underwent primary PCI and thrombectomy. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality and stroke in patients undergoing primary PCI and those who underwent thrombectomy.

RESULTS: We identified 409,910 total hospitalizations who underwent primary PCI. Thrombectomy was used in 62,446 records (15.2%) with no change in the trend over the study period (p trend = 0.52). Thrombectomy was more utilized in patients who had more cardiogenic shock and use of mechanical circulatory devices. The overall incidence of in-hospital mortality and stroke were 5.6% and 1.1%, respectively. The incidence of in-hospital mortality (6.7% vs. 5.4%, p < 0.001) and strokes (1.3% vs. 1.0%, p < 0.001) were higher in the thrombectomy group. On multivariable regression analysis adjusting for high-risk features, thrombectomy was not independently associated with in-hospital mortality [1.036, 95% CI (0.993-1.080), p = 0.100], but was associated with a higher risk of stroke [OR 1.186, 95% CI (1.097-1.283), p < 0.001].

CONCLUSION: During primary PCI, thrombectomy was used in 1 of 6 cases, and its use has been stable over 2016-2018. The use of thrombectomy was associated with a higher risk of stroke, but not in-hospital death.

PubMed ID

34167914

ePublication

ePub ahead of print