Outcomes of patients with atrial fibrillation undergoing percutaneous coronary intervention analysis of national inpatient sample

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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
DOIs
StatePublished - Jan 1 2019

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Percutaneous Coronary Intervention
Atrial Fibrillation
Inpatients
Cardiogenic Shock
Mortality
Peripheral Arterial Disease
International Classification of Diseases
Chronic Renal Insufficiency
Cardiac Arrhythmias
Coronary Artery Disease
Myocardial Infarction
Databases

Keywords

  • Anticoagulants/antithrombins
  • Antiplatelet therapy
  • Balloon angioplasty
  • Bleeding
  • Complications
  • Epidemiology
  • PCI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes of patients with atrial fibrillation undergoing percutaneous coronary intervention analysis of national inpatient sample. / Shanmugasundaram, Madhan; Dhakal, Bishnu P.; Murugapandian, Sangeetha; Hashemzadeh, Mehrtash; Paul, Timir; Movahed, Mohammad R.

In: Cardiovascular Revascularization Medicine, 01.01.2019.

Research output: Contribution to journalArticle

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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.",
keywords = "Anticoagulants/antithrombins, Antiplatelet therapy, Balloon angioplasty, Bleeding, Complications, Epidemiology, PCI",
author = "Madhan Shanmugasundaram and Dhakal, {Bishnu P.} and Sangeetha Murugapandian and Mehrtash Hashemzadeh and Timir Paul and Movahed, {Mohammad R}",
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AU - Shanmugasundaram, Madhan

AU - Dhakal, Bishnu P.

AU - Murugapandian, Sangeetha

AU - Hashemzadeh, Mehrtash

AU - Paul, Timir

AU - Movahed, Mohammad R

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N2 - 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.

AB - 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.

KW - Anticoagulants/antithrombins

KW - Antiplatelet therapy

KW - Balloon angioplasty

KW - Bleeding

KW - Complications

KW - Epidemiology

KW - PCI

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