BACKGROUND: There are limited data on the use of intravascular ultrasound (IVUS), optical coherence tomography (OCT), and fractional flow reserve (FFR) during acute myocardial infarction (AMI). OBJECTIVES: To assess the temporal trends of IVUS, OCT, and FFR use in AMI. METHODS: A retrospective cohort study from the National Inpatient Sample (2004-2014) was designed to include AMI admissions that received coronary angiography. Administrative codes were used to identify percutaneous coronary intervention (PCI), IVUS, OCT, and FFR. Outcomes included temporal trends, inhospital mortality and resource utilization stratified by IVUS, OCT, or FFR use. RESULTS: In 4,419,973 AMI admissions, IVUS, OCT, and FFR were used in 2.6%, 0.1%, and 0.6%, respectively. There was a 22-fold, 118-fold, and 33-fold adjusted increase in IVUS, OCT, and FFR use, respectively, in 2014 compared to the first year of use. Non-ST-elevation AMI presentation, male sex, private insurance coverage, admission to a large urban hospital, and absence of cardiac arrest and cardiogenic shock were associated with higher IVUS, OCT, or FFR use. PCI was performed in 83.2% of the IVUS, OCT, or FFR cohort compared to 64.2% of the control group (p < .001). The cohort with IVUS/OCT/FFR use had lower inhospital mortality (adjusted odds ratio 0.53 [95% confidence interval 0.50-0.56]), more frequent discharges to home (83.7% vs. 76.8%), shorter hospital stays (4.3 ± 4.4 vs. 5.0 ± 5.5 days) and higher hospitalization costs ($90,683 ± 74,093 vs. $74,671 ± 75,841). CONCLUSIONS: In AMI, the use of IVUS, OCT, and FFR has increased during 2004-2014. Significant patient and hospital-level disparities exist in the use of these technologies.
BACKGROUND: There are limited data on the use of intravascular ultrasound (IVUS), optical coherence tomography (OCT), and fractional flow reserve (FFR) during acute myocardial infarction (AMI). OBJECTIVES: To assess the temporal trends of IVUS, OCT, and FFR use in AMI. METHODS: A retrospective cohort study from the National Inpatient Sample (2004-2014) was designed to include AMI admissions that received coronary angiography. Administrative codes were used to identify percutaneous coronary intervention (PCI), IVUS, OCT, and FFR. Outcomes included temporal trends, inhospital mortality and resource utilization stratified by IVUS, OCT, or FFR use. RESULTS: In 4,419,973 AMI admissions, IVUS, OCT, and FFR were used in 2.6%, 0.1%, and 0.6%, respectively. There was a 22-fold, 118-fold, and 33-fold adjusted increase in IVUS, OCT, and FFR use, respectively, in 2014 compared to the first year of use. Non-ST-elevation AMI presentation, male sex, private insurance coverage, admission to a large urban hospital, and absence of cardiac arrest and cardiogenic shock were associated with higher IVUS, OCT, or FFR use. PCI was performed in 83.2% of the IVUS, OCT, or FFR cohort compared to 64.2% of the control group (p < .001). The cohort with IVUS/OCT/FFR use had lower inhospital mortality (adjusted odds ratio 0.53 [95% confidence interval 0.50-0.56]), more frequent discharges to home (83.7% vs. 76.8%), shorter hospital stays (4.3 ± 4.4 vs. 5.0 ± 5.5 days) and higher hospitalization costs ($90,683 ± 74,093 vs. $74,671 ± 75,841). CONCLUSIONS: In AMI, the use of IVUS, OCT, and FFR has increased during 2004-2014. Significant patient and hospital-level disparities exist in the use of these technologies.
Authors: Saraschandra Vallabhajosyula; Sri Harsha Patlolla; Shannon M Dunlay; Abhiram Prasad; Malcolm R Bell; Allan S Jaffe; Bernard J Gersh; Charanjit S Rihal; David R Holmes; Gregory W Barsness Journal: Circ Heart Fail Date: 2020-02-14 Impact factor: 8.790
Authors: Saraschandra Vallabhajosyula; Viral K Desai; Pranathi R Sundaragiri; Wisit Cheungpasitporn; Rajkumar Doshi; Vikas Singh; Allan S Jaffe; Amir Lerman; Gregory W Barsness Journal: Ann Transl Med Date: 2021-07
Authors: Saraschandra Vallabhajosyula; Saarwaani Vallabhajosyula; Shannon M Dunlay; Sharonne N Hayes; Patricia J M Best; Jorge A Brenes-Salazar; Amir Lerman; Bernard J Gersh; Allan S Jaffe; Malcolm R Bell; David R Holmes; Gregory W Barsness Journal: Mayo Clin Proc Date: 2020-09 Impact factor: 7.616
Authors: Saraschandra Vallabhajosyula; Lina Ya'Qoub; Mandeep Singh; Malcolm R Bell; Rajiv Gulati; Wisit Cheungpasitporn; Pranathi R Sundaragiri; Virginia M Miller; Allan S Jaffe; Bernard J Gersh; David R Holmes; Gregory W Barsness Journal: Circ Heart Fail Date: 2020-09-29 Impact factor: 8.790
Authors: Saraschandra Vallabhajosyula; Shiva P Ponamgi; Sanskriti Shrivastava; Pranathi R Sundaragiri; Virginia M Miller Journal: FASEB J Date: 2020-07 Impact factor: 5.191
Authors: Saraschandra Vallabhajosyula; Sri Harsha Patlolla; P Elliott Miller; Wisit Cheungpasitporn; Allan S Jaffe; Bernard J Gersh; David R Holmes; Malcolm R Bell; Gregory W Barsness Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-06-12
Authors: Saraschandra Vallabhajosyula; Vinayak Kumar; Pranathi R Sundaragiri; Wisit Cheungpasitporn; Malcolm R Bell; Mandeep Singh; Allan S Jaffe; Gregory W Barsness Journal: PLoS One Date: 2020-12-18 Impact factor: 3.240
Authors: Gaurav Aggarwal; Sri Harsha Patlolla; Saurabh Aggarwal; Wisit Cheungpasitporn; Rajkumar Doshi; Pranathi R Sundaragiri; Alejandro A Rabinstein; Allan S Jaffe; Gregory W Barsness; Marc Cohen; Saraschandra Vallabhajosyula Journal: J Am Heart Assoc Date: 2021-01-05 Impact factor: 5.501
Authors: Saraschandra Vallabhajosyula; Aditi Shankar; Sri Harsha Patlolla; Abhiram Prasad; Malcolm R Bell; Jacob C Jentzer; Shilpkumar Arora; Saarwaani Vallabhajosyula; Bernard J Gersh; Allan S Jaffe; David R Holmes; Shannon M Dunlay; Gregory W Barsness Journal: ESC Heart Fail Date: 2020-04-02