Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes
Background: Rotational atherectomy (RA) is an important technique for the management of severe coronary calcification. However, optimal rotational speed is yet to be defined. Methods: A total of 372 coronary heart disease (CHD) patients were retrospectively analyzed between February 2017 and January...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-01-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401013 |
| _version_ | 1797937810733268992 |
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| author | Jiawei Wu Guangquan Qiu Hao Hu Li-Kun Ma |
| author_facet | Jiawei Wu Guangquan Qiu Hao Hu Li-Kun Ma |
| author_sort | Jiawei Wu |
| collection | DOAJ |
| description | Background: Rotational atherectomy (RA) is an important technique for the management of severe coronary calcification. However, optimal rotational speed is yet to be defined. Methods: A total of 372 coronary heart disease (CHD) patients were retrospectively analyzed between February 2017 and January 2022. The patients were divided into four groups based on the maximum RA speed: group 1 (<150,000 rpm, 76 cases), group 2 (150,000 rpm, 156 cases), group 3 (160,000 rpm, 90 cases) and group 4 (≥170,000 rpm, 50 cases). The outcomes analyzed were procedural complications, six-months major cardiovascular and cerebrovascular events (MACCE) and chronic heart failure. Results: Patients in group 4 had a higher incidence of slow flow during the RA operation (p = 0.025). There was no significant difference in other complications among the four groups, as well as six-month MACCE. After adjusting for confounding factors, increase in rotational speed led to a higher probability of slow flow (p for non-linearity = 0.131; adjusted model) and MACCE (p for non-linearity = 0.183; adjusted model). Logistic regression analysis showed that rotational speed was a predictor of slow flow during RA operation (OR = 1.25, 95% CI: 1.05~1.49, p = 0.01). Moreover, the analysis demonstrated that individuals with lower rotational speed (<150,000 rpm) were at 230% higher risk of vasospasm compared with a higher rotational speed (160,000 rpm) (OR = 3.3, 95% CI: 1.08~10.09, p = 0.036). Conclusions: CHD patients treated with a rotational speed of ≥170,000 rpm had a higher risk of slow flow after RA. Rotational speed is an independent risk factor for slow flow in CHD patients. Moreover, a rotational speed of <150,000 rpm was associated with a higher risk of vasospasm compared with rotational speed of 160,000 rpm. There was no significant difference in six-month outcomes in comparison to elective CHD patients with different rotational speeds, and the probability of MACCE was intensified with increase in rotational speed. |
| first_indexed | 2024-04-10T18:50:04Z |
| format | Article |
| id | doaj.art-24023ab4d33144cd99720aeaf9f0496d |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-10T18:50:04Z |
| publishDate | 2023-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-24023ab4d33144cd99720aeaf9f0496d2023-02-01T07:32:12ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-01-012411310.31083/j.rcm2401013S1530-6550(22)00766-9Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month OutcomesJiawei Wu0Guangquan Qiu1Hao Hu2Li-Kun Ma3Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, 230001 Hefei, Anhui, ChinaDepartment of Cardiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, 230001 Hefei, Anhui, ChinaDepartment of Cardiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, 230001 Hefei, Anhui, ChinaDepartment of Cardiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, 230001 Hefei, Anhui, ChinaBackground: Rotational atherectomy (RA) is an important technique for the management of severe coronary calcification. However, optimal rotational speed is yet to be defined. Methods: A total of 372 coronary heart disease (CHD) patients were retrospectively analyzed between February 2017 and January 2022. The patients were divided into four groups based on the maximum RA speed: group 1 (<150,000 rpm, 76 cases), group 2 (150,000 rpm, 156 cases), group 3 (160,000 rpm, 90 cases) and group 4 (≥170,000 rpm, 50 cases). The outcomes analyzed were procedural complications, six-months major cardiovascular and cerebrovascular events (MACCE) and chronic heart failure. Results: Patients in group 4 had a higher incidence of slow flow during the RA operation (p = 0.025). There was no significant difference in other complications among the four groups, as well as six-month MACCE. After adjusting for confounding factors, increase in rotational speed led to a higher probability of slow flow (p for non-linearity = 0.131; adjusted model) and MACCE (p for non-linearity = 0.183; adjusted model). Logistic regression analysis showed that rotational speed was a predictor of slow flow during RA operation (OR = 1.25, 95% CI: 1.05~1.49, p = 0.01). Moreover, the analysis demonstrated that individuals with lower rotational speed (<150,000 rpm) were at 230% higher risk of vasospasm compared with a higher rotational speed (160,000 rpm) (OR = 3.3, 95% CI: 1.08~10.09, p = 0.036). Conclusions: CHD patients treated with a rotational speed of ≥170,000 rpm had a higher risk of slow flow after RA. Rotational speed is an independent risk factor for slow flow in CHD patients. Moreover, a rotational speed of <150,000 rpm was associated with a higher risk of vasospasm compared with rotational speed of 160,000 rpm. There was no significant difference in six-month outcomes in comparison to elective CHD patients with different rotational speeds, and the probability of MACCE was intensified with increase in rotational speed.https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401013coronary heart diseaserotational atherectomyrotational speed |
| spellingShingle | Jiawei Wu Guangquan Qiu Hao Hu Li-Kun Ma Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes Reviews in Cardiovascular Medicine coronary heart disease rotational atherectomy rotational speed |
| title | Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes |
| title_full | Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes |
| title_fullStr | Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes |
| title_full_unstemmed | Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes |
| title_short | Rotational Atherectomy in Coronary Heart Disease Patients with Different Rotational Speed: In Hospital and Six-Month Outcomes |
| title_sort | rotational atherectomy in coronary heart disease patients with different rotational speed in hospital and six month outcomes |
| topic | coronary heart disease rotational atherectomy rotational speed |
| url | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401013 |
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