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Predictors of periprocedural myocardial infarction after rotational atherectomy.
Blaszkiewicz, Michal; Florek, Kamila; Zimoch, Wojciech; Kübler, Piotr; Wanha, Wojciech; Wojakowski, Wojciech; Pawlus, Pawel; Reczuch, Krzysztof.
Afiliación
  • Blaszkiewicz M; Students' Scientific Group of Invasive Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
  • Florek K; Students' Scientific Group of Invasive Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
  • Zimoch W; Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
  • Kübler P; Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
  • Wanha W; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
  • Wojakowski W; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
  • Pawlus P; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
  • Reczuch K; Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Postepy Kardiol Interwencyjnej ; 20(1): 62-66, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38616938
ABSTRACT

Introduction:

Rotational atherectomy (RA) presents superior efficacy over traditional balloon angioplasty in managing calcified plaques, albeit being associated with a perceived heightened aggressiveness and increased risk of periprocedural complications.

Aim:

To assess the frequency and predictive factors of periprocedural myocardial infarction (MI) following RA. Material and

methods:

This was a retrospective observational study, encompassing 534 patients. The definition of periprocedural MI was consistent with the 4th universal definition of MI.

Results:

Periprocedural MI occurred in 45 (8%) patients. This subset tended to be older (74.6 ±8.2 vs. 72 ±9.3%; p = 0.04) with SYNTAX Score (SS) > 33 points (p = 0.01), alongside elevated rates of no/slow flow (p = 0.0003). These patients less often fulfilled the indication for RA, which is a non-dilatable lesion. The incidence of traditional risk factors was similar in both groups. Univariable logistic regression models revealed male gender (OR = 0.54; p = 0.04), non-dilatable lesion (OR = 0.41; p = 0.01), prior coronary artery bypass grafting (CABG) (OR = 0.07; p = 0.01) as negative and SS > 33 (OR = 2.8; p = 0.02), older age (OR = 1.04; p = 0.04), no/slow flow (OR = 7.85; p = 0.002) as positive predictors. The multivariable model showed that occurrence of no/slow flow (OR = 6.7; p = 0.02), SS > 33 (OR = 2.95; p = 0.02), non-dilatable lesion (OR = 0.42; p = 0.02), and prior CABG (OR = 0.08; p = 0.02) were independent predictors of periprocedural MI.

Conclusions:

Periprocedural MI after RA was not an uncommon complication, occurring in nearly one-twelfth of patients. Our analysis implicated female gender, older age, and more severe coronary disease in its occurrence. As expected, the presence of no/slow flow amplified the risk of periprocedural MI, whereas prior CABG and non-dilatable lesions mitigated this risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Postepy Kardiol Interwencyjnej Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Polonia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Postepy Kardiol Interwencyjnej Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Polonia