OR06-9
Recent Trends in PCI Outcomes for Older Acute Coronary Syndrome Patients with a History of CABG: 2016-2020
Presenter
Sidhartha G Senapati, MD, Texas Tech University Health Sciences Center, El Paso, TX
Sidhartha G Senapati, MD1, Vamsikalyan Borra2, Himaja dutt Chigurupati, MD3, Sivaram Neppala, MD4, Dhanush Kolli, MBBS5, Sindhuja Kukkala, MD6, Sri Mani Krishna Satvik SMK Matta7, Jyoti Yadav8, Jithin Teja T Kolli8, Srivatsa Surya Vasudevan, MD9 and Rupak Desai, MBBS10, (1)Texas Tech University Health Sciences Center, El Paso, TX, (2)The University of Texas Rio Grande Valley, WESLACO, TX, (3)New York Medical College at Saint Michael's Medical Center, Newark, NJ, (4)University of Texas, San Antonio, TX, (5)Kasturba Medical College, Vijayawada, Andhra Pradesh, India, (6)Department of Internal Medicine, St. Luke's hospital, Chesterfield, MO, (7)Siddhartha Medical College, Vijayawada, Andhra Pradesh, India, (8)JSS Medical College, Mysore, Karnataka, India, (9)Louisiana State University Health Science Cente, Shereveport, LA, (10)Independent Researcher, Atlanta, GA
Keywords: Acute Coronary Syndromes (ACS)
Background:
In the last decade, PCI techniques advanced, but recent trends in high-risk populations, especially prior CABG patients, lack sufficient data. This study explores current PCI outcomes in older ACS patients with a CABG history, addressing the need for tailored insights for this at-risk group.
Methods:
Using the 2016-2020 National Inpatient Sample database and relevant ICD-10 CM codes, we examined trends in PCI outcomes for ACS patients aged >65 with a history of CABG. Primary outcomes were measured to assess the observed trends. Results:
Among 94,610 patients, 74.5% were male and 84.1% were of white ethnicity, with a median age of 75 years. 94.6% underwent non-elective PCI. Common comorbidities included hyperlipidemia (83.7%), smoking (40%), complicated diabetes (34.6%), and hypertension (53.7%). Statistically significant variations were observed in post-catheterization-related bleeding (PC-B), post-procedural respiratory failure (PP-RF), and Impella usage post-PCI (all P<0.001). There were declining trends in PC-B (1.5% in 2016 vs. 0.7% in 2020, P<0.001) and PP-RF (0.3% in 2016 vs. 0.2% in 2020, P<0.001), with an increase in Impella usage post-PCI (1.2% in 2016 vs. 2.1% in 2020). Following PCI, no statistically significant differences were noted in outcomes such as all-cause mortality (ACM), intracranial bleed (IC-B), cardiac arrest (CA), post-procedural stroke (PP-S), cardiogenic shock, and intra-aortic balloon pump (IABP) usage. Conclusions:
Higher-risk patients, like those with prior CABG, show improved outcomes with advanced diagnostics, therapeutics, and hemodynamic support devices, reducing mortality and morbidity trends.
