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Predictors and trends of contrast use and radiation exposure in a large cohort of patients treated with percutaneous coronary interventions: Chronic total occlusion analysis based on a national registry
Affiliations- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Department of Clinical Rehabilitation, University of Physical Education, Krakow, Poland
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
- Department of Cardiology, Hospital of Invasive Cardiology IKARDIA, Nałęczów, Poland
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Abstract
Background: The aim herein, was to assess predictors and current trends of radiation exposure and total contrast amount use in patients treated with percutaneous coronary intervention within chronic total occlusion (CTO PCI) and non-CTO PCI. Methods: Based on a nationwide registry (ORPKI), 535,857 patients treated with PCI between 2014 and 2018 were analysed. The study included 12,572 (2.34%) patients treated with CTO PCI. The CTO PCI and non-CTO PCI groups were compared before and after propensity score matching (PSM). Multifactorial mixed regression models were used to assess predictors of contrast amount use and radiation exposure. Results: The mean total contrast dose and radiation exposure decrease reached statistical significance in following years for the CTO PCI (p = 0.002 and p < 0.001) and non-CTO PCI groups (p < 0.001 and p < 0.001). Multifactorial analysis revealed that non-CTO PCI was a strong independent predictor of lower total contrast dose (estimate: –17.41; 95% confidence interval [CI]: –18.45 to –16.49, p < 0.001) and radiation exposure (estimate: –264.28; 95% CI: –273.75 to –254.81, p < 0.001). After PSM, it was confirmed that CTO PCI was an independent predictor of greater radiation exposure (estimate: 328.6; 95% CI: 289.1–368.1; p < 0.001) and total contrast dose (estimate: 30.5; 95% CI: 27.28–33.74; p < 0.001). Conclusions: Contrast dose and radiation exposure have decreased in previous years with regard to the CTO PCI and non-CTO PCI groups. CTO PCI was found to be an independent predictor of greater total contrast dose and radiation exposure in the overall group of patients treated with PCI.
Abstract
Background: The aim herein, was to assess predictors and current trends of radiation exposure and total contrast amount use in patients treated with percutaneous coronary intervention within chronic total occlusion (CTO PCI) and non-CTO PCI. Methods: Based on a nationwide registry (ORPKI), 535,857 patients treated with PCI between 2014 and 2018 were analysed. The study included 12,572 (2.34%) patients treated with CTO PCI. The CTO PCI and non-CTO PCI groups were compared before and after propensity score matching (PSM). Multifactorial mixed regression models were used to assess predictors of contrast amount use and radiation exposure. Results: The mean total contrast dose and radiation exposure decrease reached statistical significance in following years for the CTO PCI (p = 0.002 and p < 0.001) and non-CTO PCI groups (p < 0.001 and p < 0.001). Multifactorial analysis revealed that non-CTO PCI was a strong independent predictor of lower total contrast dose (estimate: –17.41; 95% confidence interval [CI]: –18.45 to –16.49, p < 0.001) and radiation exposure (estimate: –264.28; 95% CI: –273.75 to –254.81, p < 0.001). After PSM, it was confirmed that CTO PCI was an independent predictor of greater radiation exposure (estimate: 328.6; 95% CI: 289.1–368.1; p < 0.001) and total contrast dose (estimate: 30.5; 95% CI: 27.28–33.74; p < 0.001). Conclusions: Contrast dose and radiation exposure have decreased in previous years with regard to the CTO PCI and non-CTO PCI groups. CTO PCI was found to be an independent predictor of greater total contrast dose and radiation exposure in the overall group of patients treated with PCI.
Keywords
contrast dose; chronic total occlusion, percutaneous coronary intervention, radiation exposure
About this articleTitle
Predictors and trends of contrast use and radiation exposure in a large cohort of patients treated with percutaneous coronary interventions: Chronic total occlusion analysis based on a national registry
Journal
Issue
Article type
Original Article
Published online
2021-10-08
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2374
Article views/downloads
491
DOI
Pubmed
Keywords
contrast dose
chronic total occlusion
percutaneous coronary intervention
radiation exposure
Authors
Rafał Januszek
Leszek Bryniarski
Zbigniew Siudak
Krzysztof Piotr Malinowski
Sławomir Surowiec
Krzysztof Bryniarski
Magdalena Jędrychowska
Wojciech Wańha
Krzysztof Bartuś
Wojciech Wojakowski
Jarosław Wójcik
Jacek Legutko
Andrzej Surdacki
Stanisław Bartuś
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