PMID- 35076020
OWN - NLM
STAT- MEDLINE
DCOM- 20220725
LR  - 20230723
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Print)
IS  - 1774-024X (Linking)
VI  - 18
IP  - 4
DP  - 2022 Jul 22
TI  - Trends and predictors of radiation exposure in percutaneous coronary 
      intervention: the PROTECTION VIII study.
PG  - e324-e332
LID - EIJ-D-21-00856 [pii]
LID - 10.4244/EIJ-D-21-00856 [doi]
AB  - BACKGROUND: Percutaneous coronary intervention (PCI) is indispensable in 
      cardiology; however, exposure to potentially harmful ionising radiation remains a 
      concern. AIMS: This study was designed to assess the PCI-related radiation dose 
      over the last decade and to identify predictors of increased dose exposure. 
      METHODS: The PROcedural radiaTion dose Exposure in percutaneous Coronary 
      intervenTION (PROTECTION VIII) study included all PCIs reported to a German 
      quality assurance programme between 2008 and 2018. Dose area product (DAP) and 
      radiation time were analysed. Effective dose (ED) was estimated (ED=DAP*k; 
      conversion coefficient k=0.0022 mSv/cGy*cm(2)). Multivariate linear regression 
      analysis was used to identify predictors associated with a clinically relevant 
      increase of radiation dose (ED >/=1 mSv). RESULTS: We enrolled 3,704,986 patients 
      undergoing PCI (median age 70 years, 30% female). Indications were chronic 
      coronary syndrome (37.5%), unstable angina pectoris and non-ST-segment elevation 
      myocardial infarction (non-STEMI; 33.2%) and STEMI (18.5%). Median DAP was 4,203 
      (interquartile range [IQR] 2,313-7,300) cGy*cm, ED was 9.2 mSv and median 
      radiation time was 9.2 (IQR 5.8-15.0) min. Within the 10-year period, radiation 
      exposure was reduced by 36% (p<0.001) and resulted in a median DAP of 3,070 
      cGy*cm (ED 6.8 mSv) in 2018. A significant 5.3-fold variability of median DAP was 
      observed between catheterisation laboratories (p<0.001). We identified 
      patient-related (gender, coronary artery bypass graft surgery, heart failure) and 
      procedure-related (coronary occlusion PCI, ostial lesion PCI, left main PCI, 
      multivessel PCI) predictors of increased radiation dose (all p<0.001). 
      CONCLUSIONS: This radiation dose survey demonstrates a considerable reduction of 
      PCI radiation exposure during the last decade. However, large variability between 
      catheterisation laboratories underlines the need for further radiation dose 
      reduction.
FAU - Stocker, Thomas J
AU  - Stocker TJ
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, 
      Ludwig-Maximilians-Universitat, Munich, Germany.
AD  - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart 
      Alliance, Munich, Germany.
AD  - European Alliance for Medical Radiation Protection Research (EURAMED): The 
      EURAMED rocc-n-roll project (www.euramed.eu).
FAU - Abdel-Wahab, Mohamed
AU  - Abdel-Wahab M
AD  - Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
FAU - Mollmann, Helge
AU  - Mollmann H
AD  - Department of Internal Medicine, Medizinische Klinik 1, St. Johannes-Hospital, 
      Dortmund, Germany.
FAU - Deseive, Simon
AU  - Deseive S
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, 
      Ludwig-Maximilians-Universitat, Munich, Germany.
AD  - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart 
      Alliance, Munich, Germany.
FAU - Massberg, Steffen
AU  - Massberg S
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, 
      Ludwig-Maximilians-Universitat, Munich, Germany.
AD  - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart 
      Alliance, Munich, Germany.
FAU - Hausleiter, Jorg
AU  - Hausleiter J
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, 
      Ludwig-Maximilians-Universitat, Munich, Germany.
AD  - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart 
      Alliance, Munich, Germany.
AD  - European Alliance for Medical Radiation Protection Research (EURAMED): The 
      EURAMED rocc-n-roll project (www.euramed.eu).
LA  - eng
PT  - Journal Article
DEP - 20220722
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
SB  - IM
MH  - Aged
MH  - Coronary Angiography/methods
MH  - *Coronary Occlusion/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - *Non-ST Elevated Myocardial Infarction
MH  - *Percutaneous Coronary Intervention/methods
MH  - Radiation Dosage
MH  - *Radiation Exposure/adverse effects
MH  - Risk Factors
MH  - *ST Elevation Myocardial Infarction/etiology
MH  - Treatment Outcome
PMC - PMC9912963
COIS- J. Hausleiter has received speaker honoraria and research support from and serves 
      as consultant for Abbott Vascular and Edwards Lifesciences. H. Mollmann has 
      received speaker/proctor honoraria from Abbott Vascular, Boston Scientific, 
      Edwards Lifesciences, Siemens Healthcare and SMT. The other authors have no 
      conflicts of interest to declare.
EDAT- 2022/01/26 06:00
MHDA- 2022/07/26 06:00
PMCR- 2023/07/22
CRDT- 2022/01/25 08:55
PHST- 2022/01/26 06:00 [pubmed]
PHST- 2022/07/26 06:00 [medline]
PHST- 2022/01/25 08:55 [entrez]
PHST- 2023/07/22 00:00 [pmc-release]
AID - EIJ-D-21-00856 [pii]
AID - 10.4244/EIJ-D-21-00856 [doi]
PST - epublish
SO  - EuroIntervention. 2022 Jul 22;18(4):e324-e332. doi: 10.4244/EIJ-D-21-00856.