Prashant Patel

PCI IN PATIENTS ON LONG TERM ANTICOAGULATION PRESENTING WITH STEMI

There is an increasing number of encounters of STEMI patients who are on long term oral anticoagulants. However, all randomized trials involving primary PCI for STEMI have excluded these patients. HCUPs Nationwide Inpatient Sample (NIS) was utilized. STEMI and long term anticoagulant use were

TCT-802 Utilization of Angioplasty and Stenting in Infrainguinal Peripheral Arterial Disease outcomes – 180 days follow-up

TCT-801 Comparison of iliac stent patency between isolated iliac lesions and combined iliofemoral lesions Pil-Ki Min, Young-Won Yoon, Byoung Kwon Lee, Bum-Kee Hong, Hyuck Moon Kwon Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of; Division of Cardiology Careggi Hospital; Gangnam Severance Hospital, Yo, Seoul, Korea, Republic of; Yonsei Universiry College of Medicine, Seoul, Korea, Republic of; Interventional Cardiologist, Seoul, Korea, Republic of

TCT-782 Peripheral arterial disease: Hospitalization Trends in USA (2003-2013)

RESULTS All submassive patients survived (see table). Major complications included: 2 intracranial bleeds, 2 hematomas requiring evacuation, 2 access site complications requiring surgery, 2 pseudoaneurysms treated successfully with thrombin injection, 6 hematomas requiring transfusion, and 2 self-limiting GI bleeds requiring transfusion. Factors associated with complications were advanced age (p<0.01), massive PE presentation (p1⁄40.02), and IVC filter placement (p<0.01), but not total thrombolytic dose administered.

TCT-773 Thrombolysis(Catheter Directed/Systemic) in Pulmonary Embolism: Predictors and Etiologies of Readmissions.

Background: Thrombolytic therapy (systemic (ST) or Cather Directed (CDT)) leads to early hemodynamic improvement in pulmonary embolism (PE) but it is unclear whether this beneficial effect persists. Limited data is available on risk of recurrent thromboembolism and bleeding on hospital discharge and its implications on hospital readmissions. Methods: The study cohort was derived from the HCUP’s National Readmission Data (NRD) 2013, sponsored by AHRQ. PE was identified by ICD 9 CM diagnosis code (415.11/12/19) in primary diagnosis filed. Readmission was defined as a subsequent hospital admission within 30 days following an index admission. The propensity score matching was used to eliminate the confounders including but not limited to age, gender, comorbidities and hospital teaching status. Hierarchical two level logistic models were used to evaluate study outcomes. Results: During the study year, of 2060 pts admitted with PE, 591 (28.69%) were treated with CDT and 1469 (71.31%) with ST. Out of this, 164 pts (7.92%) were readmitted within 30 days. The propensity score matched comparison revealed similar readmissions in CDT group compared to ST group (7.79 % vs. 8.71%, p=NS). Odds ratio for readmissions in CDT group by multivariate analysis showed similar trend (OR 0.80, 95% CI 0.59 - 1.09, p=NS). Amongst the etiologies of readmission, ST showed increased trends towards readmission secondary to bleeding complications (14.2% vs. 7.9%, p = NS), while decreased trends towards readmission secondary to hypercoagulable state (20% vs. 23.7%, p = NS) (fig 1). Significant predictors of 30 day readmissions included Age group 35-49 yrs, renal failure, anemia/ coagulopathy (fig 2). Conclusion: There is trend towards higher bleeding with ST and higher hypercoagulable state related readmissions with CDT. Large scale trials are needed to further confirm these findings which in turn may help transitioning care to outpatient settings for these patients.