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Rotational atherectomy and same day discharge: Safety and growth from a national perspective

Rotational atherectomy and same day discharge: Safety and growth from a national perspective
Rotational atherectomy and same day discharge: Safety and growth from a national perspective
Objectives We explore whether same day discharge (SDD) is a feasible and safe practice following rotational atherectomy (ROTA) treatment during elective percutaneous coronary intervention (PCI), and examine which baseline characteristics are independently associated with SDD. Background SDD following elective ROTA PCI is not recommended as per the recent SCAI consensus. However, reports show it is practiced and no previous study has evaluated its safety and feasibility. Methods Our dataset included 4,591 patients undergoing elective ROTA PCI in England & Wales within an 8-years period. Independent associations with SDD were quantified via a multiple logistic regression model and the BCIS 30-day mortality risk model was used to evaluate the safety of SDD. Results The majority of elective ROTA PCI cases remain at the hospital for overnight (ON) observation, although SDD rates increased substantially from 6.7% in 2007 to 35.5% in 2014. The use of glycoprotein IIb/IIIa antagonists, Q wave AMI, left main PCI and valvular heart disease were independently associated with ON, while patients operated underwent transradial PCI were more likely to be SDD (OR = 1.77, 95% CI [1.45–2.15]). Over the study period, observed mortality rates were not significantly higher than those expected from the BCIS risk model. Conclusions Our findings did not show superiority of the ON strategy over SDD for higher risk cases undergoing elective ROTA PCI, in terms of 30-day mortality. This is the first study to examine the safety of SDD after elective ROTA PCI and more should follow.
1522-1946
678-688
Taxiarchi, Paraskevi
94308cb4-c144-4065-a978-92c017cc3d12
Martin, Glen P.
83650e98-6a17-46c1-98b7-59301a5916aa
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Kinnaird, Tim
3cfe5aa5-eb28-4a4d-b2e4-6ea0799d85d0
Ludman, Peter
28ef305d-e09e-40a7-84b4-6ccedfb37cc8
Johnson, Thomas
e122bfc0-cd5a-4a96-8345-05d896a30de4
Kwok, Chun Shing
000170fb-8506-4c19-9481-e56d93049fef
Rashid, Muhammad
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Kontopantelis, Evangelos
0a21ca6f-4516-45f8-80fc-b10dd7db6780
Mamas, Mamas A.
41515b72-75ff-4922-bb9f-8f9c63f9f5af
Taxiarchi, Paraskevi
94308cb4-c144-4065-a978-92c017cc3d12
Martin, Glen P.
83650e98-6a17-46c1-98b7-59301a5916aa
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Kinnaird, Tim
3cfe5aa5-eb28-4a4d-b2e4-6ea0799d85d0
Ludman, Peter
28ef305d-e09e-40a7-84b4-6ccedfb37cc8
Johnson, Thomas
e122bfc0-cd5a-4a96-8345-05d896a30de4
Kwok, Chun Shing
000170fb-8506-4c19-9481-e56d93049fef
Rashid, Muhammad
f974c0d2-bd55-4d93-940e-1cce3dd0fd59
Kontopantelis, Evangelos
0a21ca6f-4516-45f8-80fc-b10dd7db6780
Mamas, Mamas A.
41515b72-75ff-4922-bb9f-8f9c63f9f5af

Taxiarchi, Paraskevi, Martin, Glen P., Curzen, Nick, Kinnaird, Tim, Ludman, Peter, Johnson, Thomas, Kwok, Chun Shing, Rashid, Muhammad, Kontopantelis, Evangelos and Mamas, Mamas A. (2020) Rotational atherectomy and same day discharge: Safety and growth from a national perspective. Catheterization and Cardiovascular Interventions, 98 (4), 678-688. (doi:10.1002/ccd.29228).

Record type: Article

Abstract

Objectives We explore whether same day discharge (SDD) is a feasible and safe practice following rotational atherectomy (ROTA) treatment during elective percutaneous coronary intervention (PCI), and examine which baseline characteristics are independently associated with SDD. Background SDD following elective ROTA PCI is not recommended as per the recent SCAI consensus. However, reports show it is practiced and no previous study has evaluated its safety and feasibility. Methods Our dataset included 4,591 patients undergoing elective ROTA PCI in England & Wales within an 8-years period. Independent associations with SDD were quantified via a multiple logistic regression model and the BCIS 30-day mortality risk model was used to evaluate the safety of SDD. Results The majority of elective ROTA PCI cases remain at the hospital for overnight (ON) observation, although SDD rates increased substantially from 6.7% in 2007 to 35.5% in 2014. The use of glycoprotein IIb/IIIa antagonists, Q wave AMI, left main PCI and valvular heart disease were independently associated with ON, while patients operated underwent transradial PCI were more likely to be SDD (OR = 1.77, 95% CI [1.45–2.15]). Over the study period, observed mortality rates were not significantly higher than those expected from the BCIS risk model. Conclusions Our findings did not show superiority of the ON strategy over SDD for higher risk cases undergoing elective ROTA PCI, in terms of 30-day mortality. This is the first study to examine the safety of SDD after elective ROTA PCI and more should follow.

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e-pub ahead of print date: 26 August 2020
Published date: October 2020

Identifiers

Local EPrints ID: 453754
URI: http://eprints.soton.ac.uk/id/eprint/453754
ISSN: 1522-1946
PURE UUID: 42438d39-0e8a-4323-a64f-df2552f1011c
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 24 Jan 2022 17:35
Last modified: 17 Mar 2024 03:02

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Contributors

Author: Paraskevi Taxiarchi
Author: Glen P. Martin
Author: Nick Curzen ORCID iD
Author: Tim Kinnaird
Author: Peter Ludman
Author: Thomas Johnson
Author: Chun Shing Kwok
Author: Muhammad Rashid
Author: Evangelos Kontopantelis
Author: Mamas A. Mamas

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