Author + information
- Matthew D. Solomona,b,
- Thomas Leonga,b,
- Sue Hee Sunga,b,
- Alda Inveissa,b,
- John B. Hernandeza,b,
- Roseann M. Whitea,b,
- Michelle P. Sosaa,b,
- Jamal Ranaa,b,
- Edward McNultya,b and
- Alan S. Goa,b
Background: Few studies have examined the predictors of long-term resource utilization after PCI.
Methods: Retrospective cohort study of adults with incident PCI from Jan 2008- Dec 2012 in Kaiser Permanente Northern California, a large, integrated delivery system. Outcomes included death, repeat PCI or CABG, and coronary heart disease (CHD)-related hospitalization and emergency room (ER) visits through Dec 2013. Multivariable Cox proportional hazards models were estimated to identify predictors of outcomes. Covariates included baseline demographics, socioeconomic status (SES), presentation type, smoking status, comorbidities, BMI, and medication adherence.
Results: Of 16,665 patients identified with incident PCI (mean 66 yrs, 29% women, 30% diabetic, 59% with index acute coronary syndrome), median follow up was 2.9 years. In the first 12 months, 5% died, 8% had repeat PCI, 20% had a CHD-hospitalization, and 33% had a CHD-ER visit. Younger age predicted higher risk of revascularization; acute presentation types were associated with increased risks of long-term resource utilization, but were of similar magnitude; smoking was a significant predictor of adverse outcomes; adherence to clopidogrel and statins was protective; an obesity paradox was observed; and SES was not a meaningful predictor.
Conclusions: Among patients with incident PCI, demographic and clinical factors strongly predicted long-term resource utilization and could inform patient-level long-term risk models.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Updates in Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1125-305
- 2017 American College of Cardiology Foundation