Am J Ther. 2026 Apr 9. doi: 10.1097/MJT.0000000000002136. Online ahead of print.
ABSTRACT
BACKGROUND: Hospital-based analyses of real-world percutaneous coronary intervention (PCI) practice remain limited.
STUDY QUESTION: How do PCI strategies in non-ST-elevation acute coronary syndromes (ACSs) compare between 2 university hospitals from European countries with different cardiovascular disease burdens, health care systems, and interventional cardiology infrastructures [University and Emergency Hospital, Bucharest, Romania (RO) and University Hospital, Essen, Germany (GER)]?
STUDY TYPE: Retrospective, observational, all-comers.
MEASURES AND OUTCOMES: All consecutive high- and very high-risk patients with non-ST-elevation ACS undergoing PCI in 2022 were analyzed regarding clinical profiles and revascularization strategies.
METHODS AND RESULTS: A total of 392 patients were included (221 RO, 171 GER). RO patients had a worse cardiovascular risk profile, with higher rates of dyslipidemia, diabetes, prior ACS, and left ventricular ejection fraction (LVEF) ≤40% (all P < 0.05). P2Y12 inhibitor pretreatment was markedly higher in RO (78.3% vs. 1.3%, P < 0.001). Despite younger age in RO (64.3 vs. 71.8 years, P < 0.001), median SYNTAX scores (12 vs. 13), left main disease (10.9% vs. 11.1%), and multivessel disease (64.3% vs. 62.6%) were comparable. Radial access (80.5% RO vs. 73.1% GER), ad hoc culprit PCI (98.6% RO vs. 93.0% GER), and complete anatomical revascularization (residual SYNTAX score ≤8; 83.3% RO vs. 77.2% GER) represented standard practice in both hospitals. Use of adjunctive PCI techniques was higher in GER, with intravascular imaging-guided PCI reported only in the German hospital (29.8% of PCIs). In-hospital major adverse cardiac and cerebrovascular events were comparable (10.4% RO vs. 7.6% GER, P > 0.05) and consistently associated with lower LVEF (P < 0.001).
CONCLUSIONS: Compared with the German cohort, the Romanian cohort had a similar coronary artery disease burden but a worse overall cardiovascular risk profile at a younger age. Arterial access, PCI timing, and revascularization completeness were similar, while adjunctive PCI techniques were used more frequently in GER. In-hospital major adverse cardiac and cerebrovascular events rates were comparable and consistently associated with lower LVEF.
PMID:41952070 | DOI:10.1097/MJT.0000000000002136