Impact of Pulmonary Hypertension on In-Hospital Outcomes and 30-Day Readmissions Following Percutaneous Coronary Interventions

医学 心理干预 经皮 急诊医学 肺动脉高压 经皮冠状动脉介入治疗 重症监护医学 内科学 心脏病学 心肌梗塞 护理部
作者
Neelkumar Patel,Bharat Narasimhan,Dhrubajyoti Bandyopadhyay,Mahmoud Amreia,Sandipan Chakraborty,Adrija Hajra,Birendra Amgai,Devesh Rai,Yiming Luo,Chayakrit Krittanawong,Amit K. Dey,Raktim K. Ghosh,Gregg C. Fonarow,Gregg M. Lanier,Teresa De Marco,Srihari S. Naidu
出处
期刊:Mayo Clinic Proceedings [Elsevier]
卷期号:96 (8): 2058-2066 被引量:3
标识
DOI:10.1016/j.mayocp.2021.03.037
摘要

To evaluate the impact of pulmonary hypertension (PH) on percutaneous coronary intervention (PCI) outcomes and 30-day all-cause readmissions by analyzing a national database.We queried the 2014 National Readmissions Database to identify patients undergoing PCI using International Classification of Diseases, Ninth Revision, Clinical Modification codes. These patients were then subcategorized based on the coded presence or absence of PH and further analyzed to determine the impact of PH on clinical outcomes, health care use, and 30-day readmissions.Among 599,490 patients hospitalized for a PCI in 2014, 19,348 (3.2%) had concomitant PH. At baseline, these patients were older with a higher burden of comorbidities. Patients with PH had longer initial hospitalizations and higher 30-day readmission rates and mortality than their non-PH counterparts. This was largely driven by cardiac causes, most commonly heart failure (20.3% vs 9.0%, P<.001) and non-ST-segment elevation myocardial infarction. Recurrent coronary events (17.5% vs 9.5%, P<.05) including ST-segment elevation myocardial infarction predominated in the non-PH group.Patients with PH undergoing PCI are a high-risk group in terms of mortality and 30-day readmission rates. Percutaneous coronary intervention in patients with PH is associated with higher rates of recurrent heart failure and non-ST-segment elevation myocardial infarction, rather than recurrent coronary events or ST-segment elevation myocardial infarction. This perhaps indicates a predominance of demand ischemia and heart failure syndromes rather than overt atherothrombosis in the etiology of chest pain in these patients.
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