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26-A-20675-ACC FIFTEEN-YEAR TRENDS IN CLINICAL OUTCOMES AMONG NSTEMI PATIENTS UNDERGOING MULTIPLE PERCUTANEOUS CORONARY INTERVENTION PROCEDURES DURING INDEX ADMISSION
Abstract   Peer reviewed

26-A-20675-ACC FIFTEEN-YEAR TRENDS IN CLINICAL OUTCOMES AMONG NSTEMI PATIENTS UNDERGOING MULTIPLE PERCUTANEOUS CORONARY INTERVENTION PROCEDURES DURING INDEX ADMISSION

Shree Laya Vemula, Rahul Singh, Karthik Seetharam, Marc L. Sukhoo-Pertab, Ofek Hai, Aleksandre Toreli, Sudhanva Hegde and Vikram Sharma
Journal of the American College of Cardiology, Vol.87(13 Supplement), p.A439
04/2026
DOI: 10.1016/j.jacc.2026.02.1073

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Abstract

Background Outcomes of multiple PCI during NSTEMI hospitalizations have not been characterized using contemporary national data. We assessed 15-year trends in outcomes among NSTEMI patients undergoing multiple PCI procedures during index admission. Methods Using the National Inpatient Sample (2008-2022), we identified NSTEMI admissions with ≥2 PCI procedures on different days, excluding STEMI, prior CABG, and transfers. Outcomes included mortality /major complications (death, rescue CABG, cardiac arrest, pericardiocentesis), hemodynamic decompensation, arrhythmia requiring intervention, major bleeding requiring transfusion, and dialysis-requiring AKI. Trends were assessed with weighted logistic regression adjusting for patient and hospital factors. Results Of 2,186,232 NSTEMI admissions, 63,845 (2.9%) underwent multiple PCI (median interval 2 days). Patients were 65.8% male, 70.4% white, mean age 64.9 years. From 2008-2022, adjusted mortality/major complications declined from 0.36% to 0.21% (OR 0.97 per year, 95% CI 0.94-0.99, p<0.01). Adjusted AKI requiring dialysis decreased from 1.8% to 0.1%, major bleeding from 0.22% to 0.11%, and hemodynamic decompensation from 1.32% to 0.77% (all p<0.01). Arrhythmia remained stable at 0.23% (p=0.9). Conclusion Complication following multiple PCI during NSTEMI admissions decreased from 2008-2022. Research distinguishing staged from unplanned repeat interventions may clarify optimal management approaches.

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