TCT-288 Trends and Outcomes of Utilization of Thrombectomy During Primary Percutaneous Coronary Intervention
Megaly M, Sedhom R, Elbadawi A, Saad M, Omer M, Brilakis E, Basir M, Jaffer FA, Zaidan M, Alqarqaz M, and Alaswad K. TCT-288 Trends and Outcomes of Utilization of Thrombectomy During Primary Percutaneous Coronary Intervention. J Am Coll Cardiol 2021; 78(19):B118-B119.
J Am Coll Cardiol
Background: The aim of this study was 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 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 (Figure 1). 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 used more in patients who had more cardiogenic shock and use of mechanical circulatory devices. The overall incidences of in-hospital mortality and stroke were 5.6% and 1.1%, respectively. The incidences 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 (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 0.99-1.08, 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 to 2018. The use of thrombectomy was associated with a higher risk of stroke but not in-hospital death.