National trends of utilization and readmission rates with intravascular ultrasound use for ST‐elevation myocardial infarction. Issue 1 (11th February 2021)

• Record Type: Journal Article
• Authors: Ya'qoub, Lina; Gad, Mohamed; Saad, Anas M.; Elgendy, Islam Y.; Mahmoud, Ahmed N.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 98:Issue 1(2021)
• Page Start: 1
• Page End: 9
• Publication Date: 2021-02-11
• Subjects: intravascular imaging -- intravascular ultrasound -- readmission -- ST‐elevation myocardial infarction; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29524
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Background: Randomized trials have confirmed that intravascular ultrasound (IVUS) guidance for percutaneous coronary interventions (PCI) improves long‐term clinical outcomes. However, data on real‐world utilization of IVUS in ST‐elevation myocardial infarction (STEMI) and the impact on short to mid‐term outcomes are scarce. We sought to evaluate the utilization and the readmission rates for IVUS‐guided PCI in the setting of STEMI. Methods: Hospitalizations with a primary diagnosis of STEMI undergoing PCI were included from the Nationwide Readmissions Database (NRD) during 2012–2017. Results: Among 809, 601 hospitalizations with STEMI undergoing PCI, 33, 644 (4.2%) underwent IVUS‐guided PCI. IVUS use increased from 4.2% in 2012 to 5.6% in 2017 ( p < .0001). After matching, in‐hospital mortality was significantly lower with IVUS use (3.9% vs. 4.6%, p < .0001). The overall readmission rates were similar in both groups. We found that readmission rates due to acute MI at 6 months (5.7% vs. 6%, p = .045) and 11 months (5.1% vs. 6.5%, p = .005) as well as the PCI and mortality rates during readmission at 11 months (2.1% vs. 3%, p = .008, and 0.7% vs. 1.4%, p = .002, respectively) were significantly lower in the IVUS group. Conclusions: The utilization of IVUS in STEMI appears to be slowly increasing. Although overall readmission rates were similar, IVUS was associated with lower in‐hospital mortality, lower rates of readmission due to acute MI at 6 and 11 months, as well as lower PCI and mortality at 11 months. Randomized trials evaluating long‐term benefits of IVUS in STEMI are needed.