• Outcomes of Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Analysis of National Inpatient Sample

    • Posted: 03/03/2020
    • Author:

      Madhan Shanmugasundaram, Bishnu P. Dhakal, Sangeetha Murugapandian, Mehrtash Hashemzadeh, Timir Paul and Mohammed R. Movahed

    • CRM2020

    Highlights

    • Nationwide inpatient sample is a set of longitudinal hospital inpatient database that was used to evaluate the outcome of AF patients with undergoing PCI.
    • There were 3,226,405 PCIs during the time period of the study of which 472,609 (14.6%) patients had AF.
    • Age adjusted inpatient mortality was significantly higher in PCI AF group compared to the PCI non-AF group (100.82±9.03 vs 54.07±8.96 per 100,000; p<0.01).
    •

    Post PCI predictors of mortality were AF (OR 1.56), CKD (OR 1.41) and PAD (OR 1.20) (p<0.001).

    Abstract

    Background

    Atrial fibrillation (AF) is the most common cardiac arrhythmia with a prevalence of 15% of patients over 80 years. Coronary artery disease co-exists in 20–30% of patients with atrial fibrillation. The need for triple anticoagulation therapy makes the management of these patients challenging following PCI.

    Methods

    Nationwide inpatient sample which is a set of longitudinal hospital inpatient databases was used to evaluate the outcome of patients with AF who underwent PCI. All patients undergoing PCI between 2002 and 2011 were included in the study. Specific ICD-9-CM codes were used to identify the study patients and their outcomes.

    Results

    There were 3,226,405 PCIs during the time period of the study of which 472,609 (14.6%) patients had AF. AF patients were older and predominantly male (60%). The number of PCIs had a declining trend from 2002 to 2011. Age adjusted inpatient mortality was significantly higher in PCI AF group compared to the PCI non-AF group (100.82 ± 9.03 vs 54.07 ± 8.96 per 100,000; P < 0.01). Post PCI predictors of mortality were AF (OR 1.56, CI 1.53–1.59), CKD (OR 1.41, CI 1.37–1.46), PAD (OR 1.20, CI 1.15–1.24), acute myocardial infarction (OR 2.42 CI 2.37–2.46 and cardiogenic shock (OR 13.92 CI 13.60–14.24) P < 0.001.

    Conclusion

    AF is common in patients undergoing PCI and those AF patients have a higher age-adjusted all cause inpatient mortality. There is a decline in total number of PCIs over time in US. Atrial fibrillation, chronic kidney disease, peripheral artery disease, MI and cardiogenic shock were associated with increased mortality following PCI.

    Author bio

    Cardiovascular Revascularization Medicine, 2020-01-01, Volume 21, Issue 1, Pages 14-19, Copyright © 2019

     

    Source:

    Read the full article on Science Direct: Outcomes of Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Analysis of National Inpatient Sample

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