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A propensity score matched valuation on feasibility of low frame rate fluoroscopy during primary percutaneous coronary intervention for patients with STEMI

  • Lin FanEmail author
  • Yukun Luo
  • Zhaoyang Chen
  • Wei Cai
  • Xianfeng Dong
  • Chaogui Lin
  • Lianglong Chen
Original Paper
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Abstract

The present study aimed to evaluate the feasibility of low frame rate fluoroscopy during primary percutaneous coronary intervention (PPCI) for patients with acute ST elevation myocardial infarction (STEMI). From January 2016 to December 2017, 165 consecutive patients with STEMI who underwent PPCI were retrospectively divided into two groups: the 7.5-frame group (fluoroscopy at 7.5 frames/s) and the 15-frame group (fluoroscopy at 15 frames/s), according to the frame rate of fluoroscopy used in their treatment. Reduction of radiation and safety of fluoroscopy at 7.5 frames/s were compared by a method of propensity score matching (PSM) with fluoroscopy at 15 frames/s. After PSM, there were 56 patients in each group. There were no differences in patients’ baseline characteristics between two groups. The 7.5-frame protocol resulted in 48.9% reduction of DAP (9917 ± 5543 cGycm2 vs. 14766 ± 7272 cGycm2, P < 0.001) and 61.1% reduction of AK (1209 ± 562 mGy vs. 1948 ± 1105 mGy, P < 0.001) with comparable procedural time (38.1 ± 15.3 min vs. 38.8 ± 17.2 min, P = 0.830), fluoroscopy time (13.0 ± 7.2 min vs. 13.5 ± 8.1 min, P = 0.703) and contrast volume (122.3 ± 39.4 ml vs. 119.3 ± 49.4 ml, P = 0.725) to the 15-frame group. Meanwhile, this new protocol didn’t increase the incidence of contrast-induced nephropathy (23.2% vs. 25.0%, OR = 0.907, 95% CI 0.381–2.157, P = 0.825) and peri-PPCI cumulative adverse events (30.4% vs. 28.6%, OR = 1.090, 95% CI 0.483–2.456, P = 0.836). In conclusion, low frame rate fluoroscopy at 7.5 frames/s is a safe and feasible strategy for reducing radiation during PPCI.

Keywords

Percutaneous coronary intervention ST elevation myocardial infarction Radiation Fluoroscopy 

Abbreviations

PCI

Percutaneous coronary intervention

PPCI

Primary percutaneous coronary intervention

STEMI

ST elevation myocardial infarction

PSM

Propensity score matching

Scr

Serum creatinine

AK

Air kerma

DAP

Dose area product

MI

Myocardial infarction

CIN

Contrast-induced nephropathy

BMI

Body mass index

CABG

Coronary artery bypass graft

LVEF

Left ventricular ejection fraction

LAD

Left anterior descending artery

LCX

Left circumflex artery

RCA

Right coronary artery

SES

Sirolimus-eluting stent

ZES

Zotarolimus-eluting stent

AEs

Adverse events

Notes

Funding

This work was supported by a Grant from national natural science foundation of China (NSFC, Grant No. 81670330) and partially by natural science foundation of Fujian Province (NSFF, Grant No. 2016J1545).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Fujian Medical University Union Hospital ethics committee approval was obtained.

Informed consent

All patients in the present study gave written informed consent. Written informed consent for the screening patients were waived by the hospital ethics committee.

Consent for publication

All of authors have given their consent for publication.

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of CardiologyInstitute of Coronary Heart Disease, Fujian Medical University Union HospitalFuzhouChina

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