![]() ![]() We then used International Classification of Diseases, Ninth Revision, Procedural Coding System (ICD-9-PCS) and International Classification of Diseases, Tenth Revision, Procedural Coding System (ICD-10-PCS) to leave only those in which PCI, defined by the deployment of either a drug-eluting stent (DES) or bare-metal stent (BMS), was performed. We used International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) who identify all hospital admissions with the primary diagnosis of myocardial infarction from NIS 2008 to 2019. The data that support the findings of this study are readily available on the public website of the HCUP. Therefore, our study was exempt from approval by our institutional review board as only openly available data from the NIS were used. The NIS protects patient confidentiality by anonymizing all entries, so the database strictly contains de-identified patient information. Beginning in the year 2012, the former Nationwide Inpatient Sample was renamed NIS for sampling all HCUP-participating hospitals in contrast to the previous method of sampling hospitals that retained all their discharges. ![]() After application of weights, it approximates more than 35 million admissions, representing 97 % of the national population. We also evaluated the association between use of intravascular imaging and in-hospital mortality.ĭeveloped by the collaboration of the Healthcare Cost and Utilization Project (HCUP) and the Agency for Healthcare Research and Quality, the National Inpatient Sample (NIS) is the largest inpatient healthcare database consisting of sampled discharges from community hospitals in the U.S., excluding long-term acute care and rehabilitation hospitals. Thus, we set out to examine trends in the uptake of intravascular imaging for patients presenting with MI from 2008 to 2019 and undergoing PCI using the largest inpatient database in the United States (U.S.). Furthermore, whether increased utilization of intravascular imaging has translated into improved outcomes in real-world practice is unresolved. As the evidence supporting the use of intravascular imaging to guide PCI in patients with MI has accumulated, , the longitudinal trajectory of adoption in contemporary practice remains unknown. While patients with acute MI have been underrepresented in prior studies, , limited data on IVUS-guided PCI in this subset has demonstrated an association with lower in-hospital mortality but limited uptake. Adoption of intravascular imaging to guide PCI has remained slow despite consistent evidence of improved outcomes. In fact, patients with acute MI may derive the greatest benefit from PCI guided with intravascular imaging. Guidance with intravascular imaging can complement angiographic data by assisting in the assessment of lesion severity, plaque characteristics, and stent optimization. Intravascular imaging-guided percutaneous coronary intervention (PCI) is associated with lower in-hospital mortality, myocardial infarction (MI), and target-lesion revascularization when compared with conventional angiography-guided PCI, ). ![]()
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