Zaman, M, Rashid, M, Ludman, P, Curzen, N, Moledina, S, Grines, C and Mamas, MA (2022) TCT-146 Left Main Stem Percutaneous Coronary Intervention: Does Onsite Surgical Cover Make a Difference? Journal of the American College of Cardiology, 80 (12). B59 - B59. ISSN 0735-1097

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Background Nonsurgical centres (NSCs) contribute to the significant capacity of overall PCI in the UK. Whilst previous studies have demonstrated similar PCI outcomes in surgical centres (SCs) vs NSCs, it is unknown whether this applies to more complex procedures such as LMS PCI. We compared patient characteristics and outcomes in left main stem (LMS) PCI performed across SCs vs NSCs in England and Wales. Methods A retrospective analysis of procedures between January 2006 and March 2020 was performed using the British Cardiovascular Intervention Society database and stratified according to the surgical status of the centre. The primary outcomes assessed were in-hospital major adverse cardiovascular and cerebrovascular events (MACCE), all-cause mortality and Bleeding Academic Research Consortium (BARC) stage 3-5 bleeding. Results 40,744 patients underwent LMS PCI during the period, of which 13,922 (34.2%) had their procedure performed at an NSC. The proportion of LMS PCI performed in NSCs increased by more than 2-fold (15.9% in 2006 to 36.7% in 2020). There was no association between surgical cover location and in-hospital mortality (OR 0.92, 95% CI 0.69-1.22), in-hospital MACCE (OR 1.00, 95% CI 0.79- 1.25), or emergency CABG (OR 1.00, 95% CI 0.95-1.06). NSCs had lower BARC 3-5 bleeding complications (OR 0.53, 95% CI 0.34-0.82). There has been an increase in LMS PCI volumes at NSCs, particularly elective LMS PCI. LMS PCI performed at NSCs was not associated with increased mortality, in-hospital MACCE, or emergency CABG, despite higher disease complexity.

Item Type: Article
Additional Information: The final version of this article and all relevant information related to it, including copyrights, can be found on the publisher website.
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Depositing User: Symplectic
Date Deposited: 10 Nov 2022 12:57
Last Modified: 10 Nov 2022 12:57

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