• Impact and Outcomes of Patients with Congestive Heart Failure Complicating Non-ST-Segment Elevation Myocardial Infarction,Results from a Nationally-Representative United States Cohort

    Highlights

    • Among patients with NSTEMI, CHF is one of the most influential predictors of poor prognosis and high in-hospital mortality.
    • CHF development either before or after NSTEMI is associated with significantly prolonged hospital stay.
    • Further prospective studies to determine and overcome barriers to early revascularization among the NSTEMI patients with CHF are needed.

    Abstract

    Introduction

    Congestive heart failure (CHF) is seen in up to 13–25% of patients with NSTEMI. Recent data describing the impact of congestive heart failure (CHF) on in-hospital outcomes in patients with non-ST-segment elevation myocardial infarction(NSTEMI) in the United States is limited. We sought to examine the in-hospital outcomes, and management of CHF in patients admitted to the hospital with NSTEMI.

    Methods

    National Inpatient Sample (NIS) database (2010–2014) was analyzed to identify patients with NSTEMI using ICD-9-CM codes. The primary outcome was in-hospital mortality. Propensity score-matching analysis compared mortality in CHF patients to matched controls without CHF.

    Results

    Of 247,624 patients with NSTEMI, 84,115 (34%) had CHF. Patients with CHF were less likely to receive percutaneous coronary intervention (PCI) [20.48% vs. 40.9%, P < 0.001] or coronary artery bypass grafting (CABG) [8.2% vs 9.6%, P < 0.001] during hospitalization. Also, they had longer lengths of stay and higher risk for in-hospital adverse outcomes. CHF was the strongest predictor of in-hospital death. The increased mortality risk was persistent after propensity matching (RR 1.27; 95% CI 1.22 to 1.33).

    Conclusion

    CHF among patients with NSTEMI is associated with increased risk for in-hospital mortality and adverse outcomes.

    Author bio

    Cardiovascular Revascularization Medicine, Copyright © 2018 Elsevier Inc.

     

    Source:

    Read the original article on Science Direct: Impact and Outcomes of Patients with Congestive Heart Failure Complicating Non-ST-Segment Elevation Myocardial Infarction,Results from a Nationally-Representative United States Cohort

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