Author + information
- Nilay Patel,
- Subir Bhatia,
- Prashant Patel,
- Shilpkumar Arora,
- Neil Patel,
- Sopan Lahewala,
- Harshil Shah,
- Ekta Aneja,
- Varun Kumar,
- Sidakpal Panaich,
- Apurva Badheka and
- Abhishek Deshmukh
Background: Atrial fibrillation (AF) is associated with an increased risk of developing coronary artery disease subsequently leading to major adverse cardiac events (MACE). However there is paucity of data comparing outcomes in non STEMI patients with and without AF.
Methods: We queried the HCUP's Nationwide Inpatient Sample (NIS) data between 2004 and 2013 using ICD9-CM code 410.7 for NSTEMI in principal diagnosis field. The cohort was then divided in two comparsion groups based on presence of AF (427.31) in secondary diagnosis fields. Hierarchical two level logistic regression models were built to evaluate outcomes of mortality and MACE (composite of mortality, reinfarction and stroke).
Results: During the study period, 827,729 (weighted 4,082,908) patients were hospitalized with a principal diagnosis of NSTEMI (62.66% age≥65 years, 42.64% female). 18.27% of this also had a diagnosis of AF. Univariate analysis revealed decreased utilization of PCI in AF patients (17.25% vs 33.05%, <0.001). After adjusting for confounders, AF was a significant independent predictor of increased mortality (OR, CI, p-value: 1.27, 1.24-1.31, <0.0001) or MACE (1.23, 1.21-1.26, <0.0001). Furthermore, in subgroup analysis, NSTEMI patients undergoing PCI were likely to have lesser reduction of odds of mortality if they also had AF (Figure 1).
Conclusions: We report nationwide data on outcomes in NSTEMI patients with concomitant AF- a combination that portends relatively poor prognosis even when patients undergo PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias and Clinical EP: Basic 1
Abstract Category: 4. Arrhythmias and Clinical EP: Basic
Presentation Number: 1107-071
- 2017 American College of Cardiology Foundation