Abstract 12802: Impact of Atrial Fibrillation on Percutaneous Coronary Intervention With Orbital Atherectomy

Abstract

Introduction: Patients with atrial fibrillation risk various complications following cardiovascular procedures. As there is a lack of data on the disparities in outcomes in atrial fibrillation patients undergoing orbital atherectomy (followed by the percutaneous intervention (PCI)), we aim to bridge this knowledge gap via our study. Methods: We queried cases of PCI between 2016-2020 via the National Inpatient Sample. Patients with a code for orbital atherectomy (followed by PCI) were retained as per past studies. We compared patient characteristics between patients with and without atrial fibrillation, and the adjusted odds ratios (aOR) of various complications were studied via logistic regression analysis. Results: Our analysis found 20710 patients (ages 18 and more) who underwent orbital atherectomy between 2016-2020 in the United States, which included 5250(25.4%) of cases with atrial fibrillation. Compared to cases without atrial fibrillation, patients with atrial fibrillation undergoing orbital atherectomy showed higher odds of various complications such as acute ischemic stroke (AIS) (aOR 1.507, p<0.01), sepsis (aOR 1.389, p<0.01), pericardial effusion (aOR 1.931, p<0.01), major bleeding (aOR 1.423, p<0.01), cardiogenic shock (aOR 1.258, p<0.01), acute kidney injury (AKI) (aOR 1.438, p<0.01), and mortality (aOR 1.298, p<0.01). While fewer cases of coronary artery dissections were noted among patients with atrial fibrillation (2.0% vs. 2.3%), the results were not statistically significant (aOR 0.862, p=0.256). Conclusions: Atrial fibrillation predisposed patients undergoing orbital atherectomy to poorer outcomes, including AKI, AIS, sepsis, pericardial effusion, major bleeding, cardiogenic shock, and death. Physicians must therefore address this issue via proper screening for cardiac arrhythmias pre- and post-procedure and maintain a close follow-up in at-risk individuals.