Author + information
- Gaurav Patel,
- Maitri Pancholy,
- Sukrut Nanavaty,
- Neha Pancholy,
- Aman Patel,
- Anvit Rai,
- John Coppola,
- Tak Kwan,
- Tejas Patel and
- Samir Pancholy
Background: The impact of atrial fibrillation (AF) on clinical outcomes after percutaneous coronary intervention (PCI) is largely unclear.
Methods: Patients 18 years of age and older undergoing PCI procedures were identified from Nationwide Inpatient Sample (NIS) data files from 1998 to 2013 by using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for PCI (00.66, 17.55, 36.0, 36.01, 36.02, 36.05, 36.06, 36.07, and 36.09). Inverse probability weighting was used to adjust for the patients’ baseline demographic characteristics. Using the predicted probability, we constructed a propensity score adjusted multivariate regression model to evaluate the independent predictors of in-hospital mortality.
Results: Of 120,721,741 patients hospitalized between 1998 and 2013, 2,194,322 patients 18 years of age and older underwent PCI. 197,532 (9%) patients had a diagnosis of AF, of which 7,381 (3.7%) patients died during hospitalization. Independent predictors of in-hospital mortality were AF (O.R=1.21, 95% C.I [1.16-1.25], P=0.0005), coronary artery bypass surgery (O.R=1.181, 95% C.I [1.10-1.27], P=0.0005), acute cerebrovascular accident (O.R=6.48, 95% C.I [6.03-6.96], P=0.0005), gastrointestinal bleed (O.R=2.11, 95% C.I [1.98-2.25], P=0.0005), acute kidney injury (O.R=3.76, 95% C.I [3.63-3.90], P=0.0005), cardiac arrest (O.R=11.10, 95% C.I [10.73-11.49], P=0.0005), cardiogenic shock (O.R=12.23, 95% C.I [11.82-12.64], P=0.0005), requirement of pericardiocentesis (O.R=9.97, 95% C.I [8.62-11.52], P=0.0005) and vascular complications (O.R=1.55, 95% C.I [1.49-1.63], P=0.0005). The model demonstrated outstanding statistical discrimination (C statistic = 0.94).
Conclusions: Presence of AF is an independent predictor of in-hospital mortality after PCI. Mechanisms and potential interventions need to be investigated to favorably modify this association.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1285-174
- 2017 American College of Cardiology Foundation