Recent studies informed by data from ACC's CathPCI Registry explore trends in PCI for stent thrombosis; contrast media dosing during PCI; acute kidney injury (AKI) and same-day discharge (SDD); and disparities in use of atherectomy and intravascular lithotripsy (IVL) during PCI. Review each study's main highlights below.

Contemporary Trends, Characteristics and Outcomes of Patients Undergoing PCI For Stent Thrombosis

Ayman Elbadawi, MD, et al., found no change in the incidence of PCI for stent thrombosis from April 2018 to June 2023. Out of more than 2 million patients undergoing PCI for acute myocardial infarction (MI) included in the analysis, 2.8% were for stent thrombosis. The majority of stent thrombosis events were classified as either early or very late, and the authors identified an association between PCI for stent thrombosis and greater likelihood of in-hospital adverse outcomes, including major adverse cardiac events, all-cause mortality, recurrent MI and major bleeding. Read more in JACC: Cardiovascular Interventions.

In an accompanying editorial comment, Manel Sabaté, MD, PhD, and Anna Sabaté-Tormos, MSc, state, "Despite the advent of newer generation drug-eluting stents with improved safety profiles, enhanced implantation techniques, wider use of intravascular imaging, and more potent antiplatelet agents, we continue to face the same type of device-related complication at a similar incidence to that observed a decade earlier."

Contemporary Contrast Media Dosing During PCI in Patients With Preexisting Renal Impairment

An analysis of 463,753 patients with an estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m² found that 51.4% received high contrast volume. Devika Aggarwal, MBBS, et al., observed an association between high contrast volume during PCI with poorer outcomes such as AKI and new need for dialysis. "Our study provides further support for the use of contrast volume less than [three] times the eGFR as a target to guide contrast dosing during PCI," they write. Read more in the Journal of Invasive Cardiology.

Association of AKI Risk and SDD Practices After PCI

In a study exploring AKI risk and SDD post PCI, Anezi Uzendu, MD, FACC, et al., found patients with higher AKI risk were less likely to be discharged same day; however, in 2022, 41.2% of patients at high risk of AKI underwent SDD, and there was notable variation across sites, even when excluding lower risk cases. More than 1 million patients from 1,325 sites were included. Read more in the Journal of the American Heart Association.

Disparities in the Use of Atherectomy and IVL For PCI

Patients with greater social deprivation, determined by residential zip codes, were less likely to undergo atherectomy and IVL during PCI, according to a study including 310,124 patients who underwent PCI for severely calcified legions between 2018 and 2023. "These results highlight potential socioeconomic disparities in the usage of atherectomy/IVL across the country," write Kyu Lee, MD, et al. Read more in the Journal of the Society for Cardiovascular Angiography & Interventions.