Author + information
- Gaurav Patel,
- Maitri Pancholy,
- Neha Pancholy,
- Sukrut Nanavaty,
- Hemant Tiwari,
- Aman Patel,
- Tejas Patel,
- John Coppola,
- Tak Kwan and
- Samir Pancholy
Background: Stent thrombosis (ST) is a devastating complication and is associated with high mortality; however, the gender-specific outcome difference in patients presenting with ST is unclear.
Methods: The Nationwide Inpatient Sample (NIS) files from 1998 to 2013 were used to extract the data. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 996.72, we extracted the patients 18 years of age and older presenting with ST as a primary diagnosis. The primary study outcome measure in-hospital mortality. We constructed a multivariate logistic regression model using the forward selection method to identify independent predictors of in-hospital mortality.
Results: Of 203,637 patients 18 years of age and older presented with ST, 4,466 (2.2%) patients died during hospitalization. In-hospital morality was significantly higher in women compared to men (2.5% vs. 2.0%, P = 0.0005). Women had a significantly higher rate of diabetes mellitus (39.0% vs. 33.8%, P = 0.0005), hypertension (70.6% vs. 67.9%, P = 0.0005), congestive heart failure (26.1% vs. 22.8%, P = 0.0005), and prior stroke (1.4% vs. 1.2%, P = 0.0005) compared to men. Female gender continued to be an independent predictor of in-hospital mortality (odds ratio [O.R.], 95% CI, P-value) (1.21, 1.13-1.30, 0.0005) after adjusting for age (1.031, 1.028-1.034, 0.0005), coronary artery bypass graft surgery (1.27, 1.16-1.39, 0.0005), ST-elevation myocardial infarction (1.37, 1.27-1.48, 0.0005), acute cerebrovascular accident (3.54, 3.04-4.12, 0.0005), gastrointestinal bleed (1.66, 1.43-1.93, 0.0005), acute kidney injury (3.02, 2.78-3.28, 0.0005), vascular complications (1.49, 1.37-1.62, 0.0005), cardiogenic shock (5.19, 4.71-5.71, 0.0005), use of mechanical circulatory support (3.86, 3.50-4.26, 0.0005), and Charlson comorbidity index (1.16, 1.14-1.19, 0.0005). ROC-derived AUC was 0.90.
Conclusions: Female gender is an independent predictor of in-hospital mortality in patients presenting with ST. Mechanisms and interventions to mitigate this gender disadvantage need to be investigated.
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: 1285-175
- 2017 American College of Cardiology Foundation