Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions

Edward L. Hannan, Zaza Samadashvili, Gary D Walford, David R. Holmes, Alice Jacobs, Samin Sharma, Stanley Katz, Spencer B. King

Research output: Contribution to journalArticle

Abstract

Objectives: Our aim was to compare longer-term outcomes for ad hoc percutaneous coronary intervention (PCI) and non-ad hoc PCI. Background: Ad hoc PCIs, whereby PCI is performed immediately after cardiac catheterization, has become the most common way of performing PCI. However, no studies have compared longer-term outcomes for ad hoc and non-ad hoc PCIs. Methods: A total of 46,565 New York State patients who underwent PCI in nonfederal New York State hospitals between January 1, 2003 and June 30, 2005 were followed through December 31, 2005, and in-hospital and longer-term outcomes were compared for ad hoc and non-ad hoc PCI patients after adjusting for differences in pre-procedural risk factors. Results: There was no difference in risk-adjusted in-hospital mortality (adjusted ad hoc/non-ad hoc odds ratio: 0.82, 95% confidence interval [CI]: 0.55 to 1.22). Ad hoc PCI patients had significantly lower 36-month mortality (adjusted hazard ratio [HR]: 0.76, 95% CI: 0.69 to 0.85, p <0.0001). Ad hoc PCI patients had significantly higher 36-month subsequent revascularization (adjusted HR: 1.11, 95% CI: 1.01 to 1.21, p = 0.03), but after excluding subsequent PCIs that occurred within 30 days of the index PCI in another vessel, the difference was no longer significant (adjusted HR: 1.03, 95% CI: 0.95 to 1.12, p = 0.43). Conclusions: On average, lower-risk patients undergo ad hoc PCI, and after risk-adjustment for differences in patient mix, ad hoc PCI patients have lower 3-year mortality rates.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume2
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

Fingerprint

Percutaneous Coronary Intervention
Confidence Intervals
Risk Adjustment
State Hospitals
Mortality
Cardiac Catheterization
Hospital Mortality
Odds Ratio

Keywords

  • ad hoc PCI
  • in-hospital mortality
  • long-term mortality
  • non-ad hoc PCI
  • subsequent revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions. / Hannan, Edward L.; Samadashvili, Zaza; Walford, Gary D; Holmes, David R.; Jacobs, Alice; Sharma, Samin; Katz, Stanley; King, Spencer B.

In: JACC: Cardiovascular Interventions, Vol. 2, No. 4, 04.2009, p. 350-356.

Research output: Contribution to journalArticle

Hannan, EL, Samadashvili, Z, Walford, GD, Holmes, DR, Jacobs, A, Sharma, S, Katz, S & King, SB 2009, 'Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions', JACC: Cardiovascular Interventions, vol. 2, no. 4, pp. 350-356. https://doi.org/10.1016/j.jcin.2009.01.006
Hannan, Edward L. ; Samadashvili, Zaza ; Walford, Gary D ; Holmes, David R. ; Jacobs, Alice ; Sharma, Samin ; Katz, Stanley ; King, Spencer B. / Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions. In: JACC: Cardiovascular Interventions. 2009 ; Vol. 2, No. 4. pp. 350-356.
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T1 - Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions

AU - Hannan, Edward L.

AU - Samadashvili, Zaza

AU - Walford, Gary D

AU - Holmes, David R.

AU - Jacobs, Alice

AU - Sharma, Samin

AU - Katz, Stanley

AU - King, Spencer B.

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N2 - Objectives: Our aim was to compare longer-term outcomes for ad hoc percutaneous coronary intervention (PCI) and non-ad hoc PCI. Background: Ad hoc PCIs, whereby PCI is performed immediately after cardiac catheterization, has become the most common way of performing PCI. However, no studies have compared longer-term outcomes for ad hoc and non-ad hoc PCIs. Methods: A total of 46,565 New York State patients who underwent PCI in nonfederal New York State hospitals between January 1, 2003 and June 30, 2005 were followed through December 31, 2005, and in-hospital and longer-term outcomes were compared for ad hoc and non-ad hoc PCI patients after adjusting for differences in pre-procedural risk factors. Results: There was no difference in risk-adjusted in-hospital mortality (adjusted ad hoc/non-ad hoc odds ratio: 0.82, 95% confidence interval [CI]: 0.55 to 1.22). Ad hoc PCI patients had significantly lower 36-month mortality (adjusted hazard ratio [HR]: 0.76, 95% CI: 0.69 to 0.85, p <0.0001). Ad hoc PCI patients had significantly higher 36-month subsequent revascularization (adjusted HR: 1.11, 95% CI: 1.01 to 1.21, p = 0.03), but after excluding subsequent PCIs that occurred within 30 days of the index PCI in another vessel, the difference was no longer significant (adjusted HR: 1.03, 95% CI: 0.95 to 1.12, p = 0.43). Conclusions: On average, lower-risk patients undergo ad hoc PCI, and after risk-adjustment for differences in patient mix, ad hoc PCI patients have lower 3-year mortality rates.

AB - Objectives: Our aim was to compare longer-term outcomes for ad hoc percutaneous coronary intervention (PCI) and non-ad hoc PCI. Background: Ad hoc PCIs, whereby PCI is performed immediately after cardiac catheterization, has become the most common way of performing PCI. However, no studies have compared longer-term outcomes for ad hoc and non-ad hoc PCIs. Methods: A total of 46,565 New York State patients who underwent PCI in nonfederal New York State hospitals between January 1, 2003 and June 30, 2005 were followed through December 31, 2005, and in-hospital and longer-term outcomes were compared for ad hoc and non-ad hoc PCI patients after adjusting for differences in pre-procedural risk factors. Results: There was no difference in risk-adjusted in-hospital mortality (adjusted ad hoc/non-ad hoc odds ratio: 0.82, 95% confidence interval [CI]: 0.55 to 1.22). Ad hoc PCI patients had significantly lower 36-month mortality (adjusted hazard ratio [HR]: 0.76, 95% CI: 0.69 to 0.85, p <0.0001). Ad hoc PCI patients had significantly higher 36-month subsequent revascularization (adjusted HR: 1.11, 95% CI: 1.01 to 1.21, p = 0.03), but after excluding subsequent PCIs that occurred within 30 days of the index PCI in another vessel, the difference was no longer significant (adjusted HR: 1.03, 95% CI: 0.95 to 1.12, p = 0.43). Conclusions: On average, lower-risk patients undergo ad hoc PCI, and after risk-adjustment for differences in patient mix, ad hoc PCI patients have lower 3-year mortality rates.

KW - ad hoc PCI

KW - in-hospital mortality

KW - long-term mortality

KW - non-ad hoc PCI

KW - subsequent revascularization

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