Abstract
The use of intravascular ultrasound during percutaneous coronary intervention does not reduce all cause in-hospital mortality but doubles the cost, with higher utilization in privately insured patients
- Sarver Heart Center, Department of Med icine, University of Arizona, Tucson, Arizona, United States
- Department of Medicine, University of Arizona, Phoenix, Arizona, United States
Introduction:
The effect of using intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) on short-term mortality is not well established.
Aim:
To evaluate any association between the use of IVUS vs. no IVUS during PCI and mortality in a large inpatient database.
Material and methods:
We used the National Inpatient Sample (NIS) database for available ICD-10 codes from 2016–2020 for IVUS and PCIs.
Results:
A total of 10,059,56 PCIs were performed. In 206,910, IVUS-guided PCI was performed vs. 9,852,359 without IVUS. Mortality did not differ between the two groups, with 2.52% mortality in the IVUS arm vs. 2.59% in no IVUS cohort, p = 0.4. The mean age of patients with IVUS use was 65.5 vs. 70.1 years without IVUS, p < 0.001. Total in-hospital cost in the IVUS group was double that without IVUS ($141,920 vs. $71,568, p < 0.001). Furthermore, IVUS utilization was significantly higher in patients with private health insurance (28.3% vs. 17.2%, p < 0.001).
Conclusions:
In-patient all-cause mortality using IVUS during PCI was similar to that in patients without IVUS utilization, but the cost was doubled, with higher utilization in privately insured patients.
Keywords
percutaneous coronary intervention (PCI), stenting, mortality, intravascular ultrasound (IVUS), coronary imaging, intracoronary imaging, optical coherence tomography, IVUS guided PCI
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