Hospital Outcomes of Spontaneous Coronary Artery Dissection With Concurrent Ventricular Arrhythmias.

Autor: Tan MC; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona.; Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, New Jersey., Yeo YH; Department of Internal Medicine/Pediatrics, Beaumont Health, Royal Oak, Michigan., Ang QX; Department of Internal Medicine, Sparrow Health System and Michigan State University, East Lansing, Michigan., Lee JZ; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Yang EH; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona., Mazzarelli JK; Department of Cardiovascular Medicine, Cooper University Health System/Cooper Medical School of Rowan University, Camden, New Jersey., Pineda JE; Department of Cardiovascular Medicine, Banner University Medical Center, Tucson, Arizona., Su W; Department of Cardiovascular Medicine, Banner University Medical Center, Tucson, Arizona., Lee KS; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona.
Jazyk: angličtina
Zdroj: Journal of the Society for Cardiovascular Angiography & Interventions [J Soc Cardiovasc Angiogr Interv] 2023 Nov 27; Vol. 3 (3Part A), pp. 101231. Date of Electronic Publication: 2023 Nov 27 (Print Publication: 2024).
DOI: 10.1016/j.jscai.2023.101231
Abstrakt: Background: While patients with spontaneous coronary artery dissection (SCAD) occasionally present with concurrent ventricular arrhythmias (VA), the impact of VA on in-hospital outcomes in the United States (US) is not well-established. This study aims to analyze in-hospital outcomes of patients with SCAD and concurrent VA and to determine the factors associated with VA occurrence in this high-risk population in the US.
Methods: Using the Nationwide Readmissions Database, our study included patients age 18 years or older who had SCAD between 2017 and 2020. We categorized the cohort into 2 groups depending on the presence of VA during hospitalization. In-hospital outcomes were assessed between SCAD patients with VA and those without. Weighted analysis was performed. We analyzed the independent factors associated with VA occurring among SCAD patients through univariable and multivariable analyses.
Results: Eight hundred seventy-seven SCAD patients were included in the study: 118 (13.5%) with VA and 759 (86.6%) without. SCAD patients with concurrent VA were associated with higher rates of early mortality (10.2% vs 2.0%; P < .01), prolonged index hospital stay (≥7 days) (33.1% vs 11.7%; P < .01), and non-home discharge (21.2% vs 5.9%; P < .01). The length of hospital stay was longer in the SCAD with concurrent VA group (7.39 days vs 3.58 days; P  < .01), and the median cumulative cost of hospitalization was also higher in this group ($31,451 vs $13,802; P < .01). SCAD patients with concurrent VA had increased in-hospital adverse events: acute heart failure, cardiac arrest, cardiogenic shock, cerebral infarction, pulmonary edema, and acute kidney injury. In multivariable analysis, the independent factors associated with VA occurrence among SCAD patients were chronic liver disease (aOR, 3.42; 95% CI, 1.43-8.20; P < .01) and heart failure (aOR, 5.63; 95% CI, 3.36-9.42; P < .01).
Conclusions: Concurrence of VA among SCAD patients was associated with poorer in-hospital outcomes. Heart failure and chronic liver disease were the independent factors associated with VA occurrence in SCAD patients.
(© 2023 The Author(s).)
Databáze: MEDLINE
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