Current US prevalence of myocardial injury patterns and clinical outcomes among hospitalised patients with familial hypercholesterolaemia: insight from the National Inpatient Sample-a retrospective cohort study.

Autor:	Kumi D; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA dennisdkumi@gmail.com., Narh JT; Department of Medicine, One Brooklyn Health, Brooklyn, New York, USA., Odoi SM; Bergstrasse District Hospital, Heppenheim, Germany., Oduro A; Department of Emergency Medicine, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana., Gajjar R; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Gwira-Tamattey E; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Karki S; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Abbasi A; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Fugar S; Division of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Alyousef T; Division of Cardiology, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 May 28; Vol. 14 (5), pp. e077839. Date of Electronic Publication: 2024 May 28.
DOI:	10.1136/bmjopen-2023-077839
Abstrakt:	Background: Familial hypercholesterolaemia (FH) increases propensity for premature atherosclerotic disease. Knowledge of inpatient outcomes among patients with FH admitted with acute myocardial injury (AMI) is limited. Objectives: Our study aimed to identify myocardial injury types, including type 1 myocardial infarction (MI), type 2 MI and takotsubo cardiomyopathy, assess lesion severity and study adverse short-term inpatient outcomes among patients with FH admitted with AMI. Setting: Our study retrospectively queried the US National Inpatient Sample from 2018 to 2020. Population: Adults admitted with AMI and dichotomised based on the presence of FH. Study Outcomes: We evaluated myocardial injury types and complexity of coronary revascularisation. Primary outcome of all-cause mortality and other clinical secondary outcomes were studied. Results: There were 3 711 765 admissions with AMI including 2360 (0.06%) with FH. FH was associated with higher odds of ST-elevation MI (STEMI) (adjusted OR (aOR): 1.62, p<0.001) and non-ST-elevation MI (NSTEMI) (aOR: 1.29, p<0.001) but lower type 2 MI (aOR: 0.39, p<0.001) and takotsubo cardiomyopathy (aOR: 0.36, p=0.004). FH was associated with higher multistent percutaneous coronary interventions (aOR: 2.36, p<0.001), multivessel coronary artery bypass (aOR: 2.65, p<0.001), higher odds of intracardiac thrombus (aOR: 3.28, p=0.038) and mechanical circulatory support (aOR: 1.79, p<0.001). There was 50% reduction in odds of all-cause mortality (aOR: 0.50, p=0.006) and lower odds of mechanical ventilation (aOR: 0.37, p<0.001). There was no difference in rate of ventricular tachycardia, cardioversion, new implantable cardioverter defibrillator implantation, cardiogenic shock and cardiac arrest. Conclusion: Among patients hospitalised with AMI, FH was associated with higher STEMI and NSTEMI, lower type 2 MI and takotsubo cardiomyopathy, higher number of multiple stents and coronary bypasses, and mechanical circulatory support device but was associated with lower all-cause mortality and rate of mechanical ventilation. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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