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Comparative Safety and Efficacy of Rotational Atherectomy in NSTE-ACS and SA Patients: A Retrospective Study
Session:
Sessão de Posters 51 - Enfarte agudo do miocárdio sem supra ST
Speaker:
Mariana Carvalho
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Mariana Ferreira Carvalho; Carolina Gonçalves; Margarida Cabral; Adriana Vazão; André Martins; Fátima Saraiva; Francisco Soares; Pedro Jerónimo Sousa; Jorge Guardado; João Morais
Abstract
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Background: Rotational atherectomy (RA) has been a recognized medical procedure for over 15 years, yet its clinical outcomes in specific high-risk groups, such as patients with <span style="font-size:11.5pt"><span style="background-color:white"><span style="font-family:"Source Sans Pro",sans-serif"><span style="color:#2a2a2a">non-ST-elevation acute coronary syndromes (NSTE-ACS</span></span></span></span>) are not thoroughly established. This study was conducted to evaluate the safety and effectiveness of RA in patients who had suffered acute or recent <span style="font-size:11.5pt"><span style="background-color:white"><span style="font-family:"Source Sans Pro",sans-serif"><span style="color:#2a2a2a">NSTE-ACS</span></span></span></span>.</span></span></span></p> <p style="text-align:start"> </p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Aims: The objective of this study was to evaluate the safety and efficacy of rotational atherectomy (RA) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) including <span style="font-size:11.5pt"><span style="background-color:white"><span style="font-family:"Source Sans Pro",sans-serif"><span style="color:#2a2a2a">non-ST-elevation myocardial infarction</span></span></span></span> and unstable angina.</span></span></span></p> <p style="text-align:start"> </p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Methods and Results: This observational retrospective registry compared outcomes of RA in patients with stable angina (SA) and NSTE-ACS. The primary endpoint was in-hospital major adverse cardiac events (MACE) and procedural complications. Out of 99 patients, 26% (26 patients) presented with NSTE-ACS, and 74% (73 patients) had SA. Angiographic success rates were comparable between the groups (NSTE-ACS: 96.2% vs. SA: 97.3%, p=0.65). Univariate analysis revealed procedural complications to be more frequent in NSTE-ACS patients (15.4% vs. 6.8% in SA, p=0.03). In-hospital MACE rates were similar (NSTE-ACS: 7.7% vs. SA: 5.5%, p=0.61). Multivariate analysis indicated a trend towards increased risk in NSTE-ACS patients, although not statistically significant. Over a median follow-up of 27.9 months, MACE was higher in the NSTE-ACS group (18.5% in NSTE-ACS vs. 12.3% in SA (p=0.10), as confirmed by multivariate analysis. </span></span></span></p> <p style="text-align:start"> </p> <p><span style="font-size:12pt"><span style="color:#000000"><span style="font-family:Calibri,sans-serif">Conclusions: In a study of 99 patients, rotational atherectomy (RA) showed similar safety and efficacy in treating patients with non-ST-elevation myocardial infarction (NSTE-ACS) and stable angina (SA). NSTE-ACS patients had a slightly higher rate of procedural complications compared to SA patients, but the in-hospital major adverse cardiac event (MACE) rates were comparable between the two groups.</span></span></span></p>
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