TY - JOUR JO - EuroIntervention TI - Trends and predictors of radiation exposure in percutaneous coronary intervention: the PROTECTION VIII study AB - <p><strong>Background:</strong> Percutaneous coronary intervention (PCI) is indispensable in cardiology; however, exposure to potentially harmful ionising radiation remains a concern.</p> <p><strong>Aims:</strong> This study was designed to assess the PCI-related radiation dose over the last decade and to identify predictors of increased dose exposure.</p> <p><strong>Methods:</strong> 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*<em>k</em>; conversion coefficient <em>k</em>=0.0022 mSv/cGy*cm<sup>2</sup>). Multivariate linear regression analysis was used to identify predictors associated with a clinically relevant increase of radiation dose (ED &ge;1 mSv).</p> <p><strong>Results:</strong> 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&lt;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&lt;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&lt;0.001).</p> <p><strong>Conclusions:</strong> 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.</p> AU - Stocker Thomas J. AU - Abdel-Wahab Mohamed AU - Möllmann Helge AU - Deseive Simon AU - Massberg Steffen AU - Hausleiter Jörg VL - 18 IS - 4 Y1 - 22/07/2022 Y1 - 2022 DOI - 10.4244/EIJ-D-21-00856 SP - e324 EP - e332 KW - acs/nste-acs KW - miscellaneous KW - radiation protection KW - stable angina KW - stemi PB - Europa Digital & Publishing SE - Coronary interventions UR - https://eurointervention.pcronline.com/article/trends-and-predictors-of-radiation-exposure-in-percutaneous-coronary-intervention-the-protection-viii-study SN - 1774-024X ER -