Zero contrast optical coherence tomography‐guided percutaneous coronary intervention in patients with non‐ST segment elevation myocardial infarction and chronic kidney disease. (25th March 2021)

• Record Type: Journal Article
• Authors: Liu, Zheng‐Yu; Yin, Zi‐hui; Liang, Cheng‐Yang; He, Jing; Wang, Chang‐Lu; Peng, Xiang; Zhang, Yu; Zheng, Zhao‐Fen; Pan, Hong‐Wei
• Other Names: Gao Runlin guestEditor.; Xu Bo guestEditor.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 97(2021)Supplement 2
• Page Start: 1072
• Page End: 1079
• Publication Date: 2021-03-25
• Subjects: chronic kidney disease -- contrast‐induced nephropathy -- optical coherence tomography -- percutaneous coronary intervention -- poststent abnormalities -- quantitative flow ratio; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29655
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To investigate a strategy for ultra‐low volume contrast percutaneous coronary intervention (PCI) with the aims of preserving renal function and observing the 90‐day clinical endpoint in patients with non‐ST‐elevated myocardial infarction (non‐STEMI) and chronic kidney disease (CKD). Background: The feasibility, safety, and clinical utility of PCI with ultra‐low radio‐contrast medium in patients with non‐STEMI and CKD are unknown. Methods: A total of 29 patients with non‐STEMI and CKD (estimated glomerular filtration rate [eGFR] of ≤60 ml/min/1.73 m 2 ) were included. Ultra‐low volume contrast PCI was performed after minimal contrast coronary angiography using zero contrast optical coherence tomography (OCT) guidance. Pre‐ and post‐PCI angiographic measurements were performed using quantitative flow ratio (QFR) for pre‐perfusion assessment and verifying improvement. Results: The median creatinine level was 2.1 (inter‐quartile range 1.8–3.3), and mean eGFR was 48 ± 8 ml/min/1.73 m 2 pre‐PCI. During the PCI procedure, OCT revealed 15 (52%) cases of abnormalities post‐dilation. There was no significant change in the creatinine level and eGFR in the short‐ or long‐term, and no major adverse events were observed. Conclusion: In non‐STEMI patients with high‐risk CKD who require revascularization, QFR and no contrast OCT‐guided ultra‐low contrast PCI may be performed safely without major adverse events.