Unknown

Dataset Information

0

Non-ST-Segment-Elevation Myocardial Infarction Among Patients With Chronic Kidney Disease: A Propensity Score-Matched Comparison of Percutaneous Coronary Intervention Versus Conservative Management.


ABSTRACT: BACKGROUND:Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS:Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD. NSTEMI admissions were identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) code 410.7. CKD admissions were identified by ICD-9-CM code 585. Propensity score-matched cohorts of patients with NSTEMI were matched for age, sex, comorbidities, race, median household income, primary payer status, and hospital characteristics. Of 4 488 795 hospitalizations for NSTEMI, 31% underwent PCI. Overall, 89% of admissions had no CKD. In addition, 32% of NSTEMI admissions with no CKD and 23%, 14%, and 22% with CKD stages 3, 4, and 5 underwent PCI, respectively. Hospitalized NSTEMI patients with CKD stages 4 and 5 had 41% and 20% less likelihood, respectively, of undergoing PCI compared with those with no CKD. Among hospitalized NSTEMI patients with no CKD or CKD stage 3, 4, or 5, PCI-treated groups had 63%, 57%, 39%, and 59% lower likelihood, respectively, of all-cause, in-hospital mortality compared with propensity score-matched medically managed groups. CONCLUSIONS:PCI use decreased among hospitalized NSTEMI patients as CKD severity increased, and all-cause, in-hospital mortality was greater for NSTEMI patients admitted with more severe CKD regardless of treatment strategy.

SUBMITTER: Bhatia S 

PROVIDER: S-EPMC5907556 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

altmetric image

Publications

Non-ST-Segment-Elevation Myocardial Infarction Among Patients With Chronic Kidney Disease: A Propensity Score-Matched Comparison of Percutaneous Coronary Intervention Versus Conservative Management.

Bhatia Subir S   Arora Shilpkumar S   Bhatia Sravya M SM   Al-Hijji Mohammed M   Reddy Yogesh N V YNV   Patel Parshva P   Rihal Charanjit S CS   Gersh Bernard J BJ   Deshmukh Abhishek A  

Journal of the American Heart Association 20180310 6


<h4>Background</h4>Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients.<h4>Methods and results</h4>Using the Nationa  ...[more]

Similar Datasets

| S-EPMC4845135 | biostudies-other
| S-EPMC8712709 | biostudies-literature
| S-EPMC4124048 | biostudies-literature
| S-EPMC5880555 | biostudies-other
| S-EPMC4990737 | biostudies-other
| S-EPMC8200089 | biostudies-literature
| S-EPMC5898983 | biostudies-literature
| S-EPMC8120407 | biostudies-literature
| S-EPMC8454141 | biostudies-literature
| S-EPMC5814984 | biostudies-literature