Background: Percutaneous Transluminal Rotational Atherectomy (PTRA) is an adjunctive therapy to percutaneous coronary intervention (PCI) in certain specific clinical scenarios in order to improve procedural results. Several predictors of outcome were reported. Age of > 75 years, diabetes, LV ejection fraction <35%, burr artery ratio >0.7 were independent predictors of death after PTRA. Despite appropriate pre-specified indication for the use of the said technique, procedural success is still not guaranteed and certain peri-procedural factors may affect the clinical and procedural outcomes. Thisstudy, therefore, investigates on the factors affecting outcomes of patient undergoing PTRA in Philippine Heart Center.
Methods: This research is a retrospective cohort single center study of 59PTRA patients in Philippine Heart Center from January 2010 to April 2015. Demographic data, clinical variables, procedural factors and in-hospital outcomes were obtained and analyzed.
Results: The mean age of patient who developed MACE was 74 years old and were predominantly male patient. Diabetes, dyslipidemia and prior CVA showed trend toward developing MACE but was not statistically significant (p value of 0.150, 0.146, & 0.131 respectively).The rest of the clinical and procedural factors were not statistically significant. All-cause mortality was at 6.8%; 4 patient died of fatal MI, while 1 patient died of severe sepsis. Complications include the following: 1 patient developed non-fatal arrhythmia; 2 patients had GI bleeding; 3 patients vascular access bleeding; and 2 patients had contrast reactions.
Conclusion: This study revealed that there was no significant difference among the clinical and procedural factors in determining outcomes of PTRA patients. Although there is a trend for diabetes, dyslipidemia and prior CVA as predictor of in-hospital outcome, it did not reach statistical significance and may prompt inclusion of more patients in the study to perhaps demonstrate a significant trend. The mortality rate is at 6.8% while the morbidity rate is at 13.5%.