17th Interventional Cardiology Workshop New Frontiers in Interventional Cardiology: December 8th, 2016, Krakow, Poland

s of original contributions from NFIC 2016 391 Advances in Interventional Cardiology 2016; 12, 4 (46) 1-P Benefits in bleeding rates and periprocedural mortality of radial approach in ST-segment elevation myocardial infarction. Propensity score analysis of data from ORPKI Polish National Registry Tomasz Tokarek1, Tomasz Wysocki2, Zbigniew Siudak1, Agata Wiktorowicz3, Jacek Legutko3, Krzysztof Żmudka1, Dariusz Dudek1 1 Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 2 Department of Cardiology, Regional Hospital, Pinczow, Poland 3 Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland Background: The utilization of the radial access (RA) for percutaneous coronary intervention (PCI) has gradually increased. Recent studies suggest an advantage over femoral access (FA) in high-risk patients presenting with ST-segment elevation myocardial infarction (STEMI). The aim was to evaluate bleeding complications and periprocedural outcomes with safety and efficacy of RA compared with FA for PCI with stent implantation in “real-world” patients with STEMI presentation from Polish National Registry. Methods: The study group consisted of 22,812 consecutive patients with STEMI treated with PCI and stent implantation between January 2014 and June 2015 in 151 tertiary invasive cardiology centers in Poland. All data were stored in electronic database of National PCI Registry (ORPKI). Patients treated with RA and FA were compared using a propensity score analysis to best match between groups. The analysis was done in the “as-treated” manner. Results: Femoral access and RA were used in 9,334 (40.9%) and 13,478 (59.1%) patients, respectively. After propensity score matching no differences in baseline characteristic between 6,542 matched pairs was found. Significantly higher total amount of contrast (191.8 ±8 ml vs. 174.8 ±68.8 ml, p = 0.0001) and lower radiation doses were used in FA (1279.5 ±1346.3 mGy vs. 1182.6 ±887 mGy, p = 0.02). More bleeding complications at puncture site after both angiography (0.17% vs. 0.02%; p = 0.004) and PCI (0.23% vs. 0.09%, p = 0.049) were reported in FA group. Periprocedural death (1.94% vs. 0.93%, p = 0.0001) and periprocedural cardiac arrest (1.44% vs. 0.96%, p = 0.01) occurred significantly more often after PCI performed with FA. Conclusions: Radial access was associated with lower incidence of periprocedural death in STEMI patients as well as a significant reduction of bleeding complications at access site. 2-P Psoriasis is associated with increased risk of allergic reaction during percutaneous interventional cardiology procedures. Data from the Polish National PCI Registry Tomasz Tokarek1, Zbigniew Siudak1, Artur Dziewierz2, Tomasz Rakowski2, Agata Wiktorowicz2, Dariusz Dudek1 1 Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 2 Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland Background: Little is known on the impact of psoriasis on the outcome of percutaneous cardiovascular procedures. The aim of this analysis was to identify the incidence of active psoriasis, baseline characteristic, and periprocedural to in-hospital outcomes in this subgroup of patients. Methods: The Polish National PCI database (ORPKI) is a mandatory registry for all percutaneous cardiology procedures performed in Poland since 2004. All consecutive patients who had coronary angiography or coronary angiography with immediate PCI in 155 interventional cardiology centers in Poland in 2014 for either stable angina or acute coronary syndrome were included. Patients with active psoriasis on admission were identified. Allergic origin of the periprocedural complication was defined if a typical reaction from rash to anaphylaxis was diagnosed. Results: There were 206,335 patients with complete records in the database. Active psoriasis was diagnosed in 830 of them (0.4%). Patients with psoriasis were younger (63.1 ±10.6 years vs. 66.2 ±10.9 years, p < 0.01), significantly more often with diabetes mellitus, arterial hypertension and chronic kidney disease. The periprocedural mortality for patients with psoriasis (0.77%) was similar to those without (0.55%; p = 0.6). Interestingly, allergic reaction occurrence during angiography was 0.77% in patients with psoriasis vs. 0.07% in patients without psoriasis (p < 0.001). In multivariate regression analysis, the diagnosis of active psoriasis was an independent predictor of the occurrence of an allergic reaction during coronary angiography/PCI with OR = 8.3 and 95% CI: 1.98–34.93 (p = 0.004). Conclusions: Psoriasis is associated with a different patient baseline profile and an increased risk for allergic reaction occurrence during the procedure. Best to our knowledge, this is the first report of such relationship and requires further study. Abstracts of original contributions from NFIC 2016s of original contributions from NFIC 2016 392 Advances in Interventional Cardiology 2016; 12, 4 (46) 3-P Characterization of restenotic tissue depending on the prevalence of neovascularization evaluated by optical coherence tomography in porcine artery model Aleksandra Błachut, Maciej Pruski, Adam Janas, Magdalena Michalak, Krzysztof Milewski, Piotr P. Buszman, Paweł E. Buszman Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland Background: Neovascularization in restenotic tissue may play a key role in neointimal proliferation and progression of neoatherosclerosis. There are still insufficient in vivo data regarding in-stent neovascularization. Methods: We evaluated 48 stent segments from 24 stents implanted in porcine model of coronary artery injury. Optical coherence tomography (OCT) was performed 90 days post implantation. All measurements and qualitative analysis were performed by two independent investigators. Microvessels were defined as well delineated low backscattering structures with diameter less than 200 microns that show a trajectory within the vessel. There were two groups: with (1) or without (2) occurrence of neovascularization. Optical coherence tomography findings were compared between both groups. Results: There were no statistically significant differences between the two groups, but lesions with microvessels had a larger average stent area (8.83 ±1.39 vs. 8.27 ±1.36, p = NS) and larger average neointimal area (2.62 ±1.46 vs. 1.95 ±0.87, p = NS) than those without microvessels. Minimal lumen cross-sectional area (CSA) were almost identical in both groups (2.56 ±0.47 vs. 2.57 ±0.33, p = NS). Conclusions: Occurrence of neovascularization might be associated with the extent of neointimal area, but further studies are required to estimate factors associated with strut neovascularization. 4-P Plaque redistribution after stenting – data from NIRS-IVUS imaging Tomasz Roleder1, Magdalena Dobrolińska2, Elżbieta Pociask3, Wojciech Wańha2, Radosław Parma2, Grzegorz Smolka2, Andrzej Ochała2, Zbigniew Gąsior1, Michał Tendera2, Wojciech Wojakowski2 1 Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland 2 Third Division of Cardiology, Medical University of Silesia, Katowice, Poland 3 KCRI, Krakow, Poland Background: The previous study using intravascular imaging presented that the part of the treated atheroma is squeezed out of the vessel by the stent and its remnants may embolize. The present study aimed to characterize the plaque redistribution with relation to its composition. Methods: The combined near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) imaging analyzed the plaque distribution after the stent implantation in vivo in patients with a stable coronary artery disease (CAD) (n = 33) and acute coronary syndromes (n = 16). Near-infrared spectroscopy detected lipids in the lesion and IVUS presented the redistribution of the plaque. The maximal lipid core burden index in a 4 mm long segment (LCBI4mm) was estimated by NIRS before and after the stent implantation, and IVUS estimated minimal lumen area (MLA), plaque burden (PB) and plaque volume pre and post implantation. Results: NIRS-IVUS imaging was performed before and after the implantation of 50 stents in 49 patients. The median plaque volume pre and post implantation was 127.45 (74.5, 186.8) mm2 vs. 99.35 (67.5, 171.5) mm2 (p < 0.001) with a median difference 19.25 (3.9, 72) mm2. The median LCBI4mm pre and post stent was 351 (157, 589) vs. 77 (3, 231) (p < 0.001) in the treated lesions, and 34 (0, 207) vs. 0 (0, 45) (p < 0.04) in segment 4 mm long proximally to the stent. Plaque burden in 4 mm proximally to the implanted stent increased from 46.23 ±11.79 to 50.36 ±9.93 post stenting (p = 0.02). The difference in the plaque volume pre and post stenting correlated with the value of LCBI4max of the treated lesion (r = 0.457, p = 0.001). The median difference in the plaque volume was higher for stented lesions with LCBI 4mm > 265 (8.2 (1.4, 19.3) vs. 24.3 (12.1, 45.0), p = 0.012) (Figure 1). Conclusions: Lipid-rich lesions characterized greater release of the atheroma remnants to the coronary artery lumen as compared to non-lipid rich lesions. The stent Abstracts of original contributions from NFIC 2016s of original contributions from NFIC 2016 393 Advances in Interventional Cardiology 2016; 12, 4 (46) implantation causes plaque shift proximally to the implanted stent.