Background: Percutaneous coronary intervention (PCI) outcomes for patients with significant calcification have been consistently inferior compared to patients without significant calcification. Procedural success and long-term outcomes after PCI have been worse in patients with severe coronary calcium. Objective: A Bayesian meta-analysis of outcomes comparing rotational atherectomy (RA) with orbital atherectomy (OA) was performed. Methods: PubMed, Embase, and Cochrane Library databases were searched through 30th November 2018 and identified 4 observational studies. Results: The primary end-point, Major Adverse Cardiac Event (MACE) composing of death, MI and stroke at 1 year was more likely with RA (OR = 1.61; 95% CI: 1.11–2.33; p = 0.01) as compared to OA. The driver of the difference in MACE between the two groups was a statistically significant difference in mortality favoring OA (OR = 4.65; 95% CI: 1.36–15.87; p = 0.01). Peri-procedural MI, the other component of the primary end-point was 1.3 times more likely in the RA arm (OR = 1.35; 95% CI 0.95–1.92; p-0.09) and was not statistically different between the groups. The odds of a vascular complication were not different in the two groups (OR = 1.26; 95% CI: 0.73–2.17; p = 0.41). In an adjusted Bayesian analysis, mortality (OR = 3.69; 95% CI: 0.30–38.51), MACE (OR = 1.68; 95% CI: 0.55–5.49), MI (OR = 1.42; 95% CI: 0.50–4.29) and dissections/perforations (OR = 0.38; 95% CI: 0.10–1.38) were not different in RA and OA groups. Conclusion: Our study is the first published Bayesian meta-analysis comparing MACE and peri-procedural outcomes in RA compared to OA. These findings lay the foundation for a randomized comparison between the two competing technologies.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:etsu-works-10390 |
| Date | 01 April 2020 |
| Creators | Sawant, Abhishek C., Panchal, Hemang, Radadiya, Dhruvil, Pomakov, Alexander, Tse, Gary, Liu, Tong, Sridhara, Srilekha, Rodriguez, Janelle, Prakash, Meghana Prakash Hiriyur, Kanwar, Nidhi, Kumar, Arnav, Banerjee, Kinjal, Wiesner, Philipp, Pershad, Ashish |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | ETSU Faculty Works |
Page generated in 0.0019 seconds