TCT-288 Trends and Outcomes of Utilization of Thrombectomy During Primary Percutaneous Coronary Intervention

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Conference Proceeding

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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.





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