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Intravascular ultrasounds in Portugal: usage trend and outcomes
Session:
Sessão de Comunicações Orais - Cardiologia de Intervenção
Speaker:
Carla Marques Pires
Congress:
CPC 2020
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Carla Marques Pires; Carlos Galvão Braga; Marco Costa; Pedro Canas Da Silva; Rui Cruz Ferreira; Rui Campante Teles; Filipe Seixo; Jorge Marques; João Costa; Helder Pereira; Pedro Pinto Cardoso; João Brum Silveira; Pedro Farto e Abreu; José Baptista; Renato Fernandes; Pedro Costa Ferreira; GRAÇA SILVA; Dinis Martins; Luis Bernardes; Francisco Pereira Machado; Fernando Matias; José Palos; Hugo Vinhas; Paulino Sousa; JOAO SILVA; Pedro Braga; Em nome dos investigadores do Registo Nacional de Cardiologia de Intervenção
Abstract
<p><strong>INTRODUCTION: </strong>The current guidelines on myocardial revascularization recommend the use of Intravascular ultrasounds (IVUS) in selected patients (pts) to optimize stent apposition (IIaB) and to assess severity and optimize treatment of unprotected left main (LM) lesions (IIaB).</p> <p> </p> <p><strong>AIMS: </strong>To evaluate the use of IVUS in the last 7 years in Portugal and to assess if the use of IVUS in LM percutaneous coronary intervention (PCI) had impact on outcomes.</p> <p> </p> <p><strong>METHODS: </strong> A multicentric retrospective study in which we evaluated the use of IVUS in the last 7 years (2012-2018) in 5 different regions of Portugal in pts submitted to LM and non-LM PCI. A multivariate analysis was performed to assess if the use of IVUS in LM PCI had impact on inhospital and 1-year follow-up (FUP) MACE (death/ myocardial infarction). <br /> </p> <p><strong>RESULTS: </strong>The present study showed a progressive increased use of IVUS in PCI in Portugal (pvalue <0,001), but with some regional asymmetries: in the North (pvalue<0,001), Center (pvalue=0,03) and Islands (pvalue=0,03) this trend to increased use was observed, but not on «Lisboa e Vale do Tejo» (pvalue=0,15) and South (pvalue=0,72).</p> <p>An overall growth in the use of IVUS in LM PCI was also documented (<em>p<0,001</em>), but again regional differences were encountered, with Center (pvalue=0, 37) and «Lisboa e Vale do Tejo» (pvalue-0,15) showing no statistically significant progression on its use in this setting.</p> <p>In addition, there was also an increased use of IVUS in non-LM PCI in Portugal (pvalue-0,02), but on regional analysis only the North showed a significant variation (pvalue-0,002).</p> <p>Subsequently, we found that inhospital MACE incidence was statistically lower in pts submitted to LM PCI with IVUS guidance (1,4 vs 3,9%, p-0,024), but this wasn’t confirmed on multivariate analysis adjusted to confounding factors (pvalue=0,309).</p> <p>At 1-year FUP of pts submitted to LM PCI, we found a trend to fewer events with IVUS guidance, but the Kaplan Meier curves (pvalue=0,07) and Cox regression analysis (pvalue=0,879) didn’t demonstrate a significant impact of IVUS on 1-year MACE.</p> <p> </p> <p><strong>CONCLUSION</strong>: This study shows that in line with current guidelines the overall use of IVUS in Portugal has been significantly increasing in the last years. Despite a trend to fewer events with IVUS guidance in LM PCI, there wasn’t a statistical impact on inhospital and 1-year MACE.</p>
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