Author + information
- Dhaval Kolte,
- Sahil Khera,
- Sahil Agrawal,
- Marjan Mujib,
- Wilbert Aronow,
- Chandrasekar Palaniswamy,
- Jay Doshi,
- Nivas Balasubramaniyam and
- John McClung
Rheumatoid arthritis (RA) is associated with accelerated atherosclerosis and significant cardiovascular morbidity and mortality.
Cross–sectional analysis of Healthcare Cost and Utilization Project's Nationwide Inpatient Sample database from 2001–2010 using ICD–9 codes to evaluate baseline demographic and clinical characteristics, in–hospital mortality and predictors of in–hospital mortality in patients with RA undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).
Of 2,311,135 patients aged ≥35 years who underwent PCI for AMI between years 2001–2010, 25,037(1.1%) had a diagnosis of RA. Patients with RA were more likely to be women, white, older and have hypertension, peripheral vascular disease, chronic pulmonary disease and anemia on admission. Use of drug–eluting stents was more in the RA population. In–hospital mortality for RA patients was 2.7% compared to 3.2% in the non–RA population [adjusted odds ratio (OR) 0.70; 95% CI 0.64–0.79]. Stepwise logistic regression identified age (OR 1.06; 95% CI 1.04–1.07), female gender (OR 1.35; 95% CI 1.06–1.72), congestive heart failure (OR 2.72; 95% CI 1.46–5.07), chronic pulmonary disease (OR 1.45; 95% CI 1.12–1.86), cerebrovascular disease (CVD) (OR 3.01; 95% CI 1.58–5.74), acute renal failure (OR 4.99; 95% CI 3.79–6.57), cardiogenic shock (OR 8.72; 95% CI 6.34–12.02), gastrointestinal bleeding (OR 3.21; 95% CI 2.12–4.88) and intra–aortic balloon pump use (OR 2.27; 95% CI 1.63–3.18) as independent predictors of in–hospital mortality. Coronary artery disease (OR 0.51; 95% CI 0.38–0.68) and dyslipidemia (OR 0.49; 95% CI 0.38–0.63) were independent negative predictors of in–hospital mortality.
Patients with RA undergoing PCI for AMI have a 30% lower in–hospital mortality. Age, female gender, congestive heart failure, CVD, chronic pulmonary disease, acute renal failure, cardiogenic shock, gastrointestinal bleeding and use of intra–aortic balloon pump are all independent predictors of in–hospital mortality. Coronary artery disease and dyslipidemia are negative predictors of in–hospital mortality in the RA population.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Complex Patients, Diabetes and Renal Insufficiency
Abstract Category: 43. TCT@ACC–i2: Complex Patients, Diabetes, Renal Insufficiency
Presentation Number: 2106–223
- 2013 American College of Cardiology Foundation