未经证实:经皮冠状动脉介入治疗(PCI)期间使用血管内超声(IVUS)或光学相干断层扫描(OCT)进行血管内成像可改善预后。但是这些技术以前在现实世界中没有得到充分利用。我们的目的是研究过去十年来美国血管内成像引导PCI使用的变化,并评估心肌梗死(MI)PCI后血管内成像与临床结局之间的关系。
UNASSIGNED:我们调查了2008年至2019年的全国住院患者样本,以计算IVUS或OCT指导下MI的PCI数量。使用Cochran-Armitage趋势检验或简单线性回归分析分类或连续结果的时间趋势。分别。多变量逻辑回归用于比较有和没有血管内成像的PCI后的结果。
UNASSIGNED:对MI进行了2,881,746次PCI。IVUS引导的PCI数量增加了309.9%,从2008年的6,180个增加到2019年的25,330个(P趋势<0.001)。PCI中IVUS的使用比例从2008年的3.4%增加到2019年的8.7%(P趋势<0.001)。OCT引导的PCIs数量增加了548.4%,从2011年的246个增加到2019年的1,595个(P趋势<0.001)。所有PCI中OCT引导的百分比从2008年的0.0%增加到2019年的0.6%(P趋势<0.001)。血管内成像引导的PCI与住院死亡率的几率较低相关(校正比值比0.66,95%置信区间0.60-0.72,p<0.001)。
UNASSIGNED:尽管血管内成像引导的PCI的数量一直在增加,尽管血管内成像与较低的死亡率相关,但仍较差.
UNASSIGNED: Intravascular imaging with either intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) is associated with improved outcomes, but these techniques have previously been underutilized in the real world. We aimed to examine the change in utilization of intravascular imaging-guided PCI over the past decade in the United States and assess the association between intravascular imaging and clinical outcomes following PCI for myocardial infarction (MI).
UNASSIGNED: We surveyed the National Inpatient Sample from 2008 to 2019 to calculate the number of PCIs for MI guided by IVUS or OCT. Temporal trends were analyzed using Cochran-Armitage trend test or simple linear regression for categorical or continuous outcomes, respectively. Multivariable logistic regression was used to compare outcomes following PCI with and without intravascular imaging.
UNASSIGNED: A total of 2,881,746 PCIs were performed for MI. The number of IVUS-guided PCIs increased by 309.9 % from 6,180 in 2008 to 25,330 in 2019 (P-trend < 0.001). The percentage of IVUS use in PCIs increased from 3.4 % in 2008 to 8.7 % in 2019 (P-trend < 0.001). The number of OCT-guided PCIs increased 548.4 % from 246 in 2011 to 1,595 in 2019 (P-trend < 0.001). The percentage of OCT guidance in all PCIs increased from 0.0 % in 2008 to 0.6 % in 2019 (P-trend < 0.001). Intravascular imaging-guided PCI was associated with lower odds of in-hospital mortality (adjusted odds ratio 0.66, 95 % confidence interval 0.60-0.72, p < 0.001).
UNASSIGNED: Although the number of intravascular imaging-guided PCIs have been increasing, adoption of intravascular imaging remains poor despite an association with lower mortality.