Abstract
BackgroundSince the long fluoroscopy time in primary PCI for ST-segment elevation myocardial infarction (STEMI) could be an indicator of delayed reperfusion, it should be important to recognize which types of lesions require longer fluoroscopy-time in primary PCI. The purpose of this study was to investigate the association of the long fluoroscopy-time with clinical factors in primary percutaneous coronary interventions (PCI).MethodsA total of 539 patients who underwent primary PCI were divided into the conventional fluoroscopy-time group (Q1-Q4: n = 434) and the long fluoroscopy-time group (Q5: n = 105) according to the quintile of the total fluoroscopy time in primary PCI. Univariate and multivariate logistic regression analyses were performed to find associations between clinical variables and the long fluoroscopy-time.ResultsIn univariate logistic regression analysis, prevalence of diabetes mellitus, hemodialysis, and previous CABG were significantly associated with the long fluoroscopy-time. In addition, complex lesion characteristics such as lesion length, lesion angle, tortuosity, and calcification were associated with the long fluoroscopy-time. In multivariable logistic regression analysis, lesion length [per 10 mm incremental: odds ratio (OR) 1.751, 95% confidence interval (CI) 1.397–2.195, P<0.001], moderate-excessive tortuosity (vs. mild tortuosity: OR 4.006, 95% CI 1.498–10.715, P = 0.006), and moderate to severe calcification (vs. none-mild calcification: OR 1.865, 95% CI 1.107–3.140, P = 0.019) were significantly associated with the long fluoroscopy-time.ConclusionsIn primary PCI for STEMI, diffuse long lesion, tortuosity, and moderate-severe calcification were associated with the long fluoroscopy-time. These complex features require special attention to reduce reperfusion time in primary PCI.
Highlights
Primary percutaneous coronary intervention (PCI) has dramatically reduced the mortality of ST-segment elevation myocardial infarction (STEMI) [1, 2]
Complex lesion characteristics such as lesion length, lesion angle, tortuosity, and calcification were associated with the long fluoroscopy-time
In multivariable logistic regression analysis, lesion length [per 10 mm incremental: odds ratio (OR) 1.751, 95% confidence interval (CI) 1.397–2.195, P
Summary
Primary percutaneous coronary intervention (PCI) has dramatically reduced the mortality of ST-segment elevation myocardial infarction (STEMI) [1, 2]. Most of the culprit lesions for STEMI are totally occluded, it is technically easier to achieve successful reperfusion in primary PCI as compared to PCI to chronic total occlusion (CTO), which are totally occluded [3, 4]. It is sometimes difficult to achieve successful reperfusion even in primary PCI [5]. Delayed reperfusion, which results in poor clinical outcomes [6, 7], can lead to long fluoroscopy-time in primary PCI. Long fluoroscopy-time would be associated with increased rates of periprocedural complications including early mortality, emergent CABG, contrast-induced nephropathy [6]. It is important for better patient’s outcomes to recognize which types of lesions require long fluoroscopy-time in primary PCI.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
