Temporal Trends, Management and Outcomes of Acute Myocardial Infarction with Concomitant Respiratory Infections
| Autor: | Saraschandra Vallabhajosyula, Dennis H. Murphree, Wisit Cheungpasitporn, Bernard J. Gersh, Sri Harsha Patlolla, David R Holme |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Pneumonia Viral Myocardial Infarction 030204 cardiovascular system & hematology Coronary Angiography 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Hospital Mortality 030212 general & internal medicine Myocardial infarction Hospital Costs Respiratory system Propensity Score Pandemics Respiratory Tract Infections Aged SARS-CoV-2 business.industry Cardiogenic shock COVID-19 Percutaneous coronary intervention Odds ratio Length of Stay medicine.disease Comorbidity Patient Discharge United States Confidence interval Concomitant Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 150:1-7 |
| ISSN: | 0002-9149 2000-2017 |
| DOI: | 10.1016/j.amjcard.2021.03.037 |
| Popis: | There are limited contemporary data on the management and outcomes of acute myocardial infarction (AMI) in patients with concomitant acute respiratory infections. Hence, using the National Inpatient Sample from 2000-2017, adult AMI admissions with and without concomitant respiratory infections were identified. We evaluated in-hospital mortality, utilization of cardiac procedures, hospital length of stay, hospitalization costs, and discharge disposition. Among 10,880,856 AMI admissions, respiratory infections were identified in 745,536 (6.9%). Temporal trends revealed a relatively stable tr end with a peak during 2008-2009. Admissions with respiratory infections were on average older (74 vs. 67 years), female (45% vs 39%), with greater comorbidity (mean Charlson comorbidity index 5.9 ± 2.2 vs 4.4 ± 2.3), and had higher rates of non-ST-segment-elevation AMI presentation (71.8% vs. 62.2%) (all p < 0.001). Higher rates of cardiac arrest (8.2% vs 4.8%), cardiogenic shock (10.7% vs 4.4%), and acute organ failure (27.8% vs 8.1%) were seen in AMI admissions with respiratory infections. Coronary angiography (41.4% vs 65.6%, p < 0.001) and percutaneous coronary intervention (20.7% vs 43.5%, p < 0.001) were used less commonly in those with respiratory infections. Admissions with respiratory infections had higher in-hospital mortality (14.5% vs 5.5%; propensity matched analysis: 14.6% vs 12.5%; adjusted odds ratio 1.25 [95% confidence interval 1.24-1.26], p < 0.001), longer hospital stay, higher hospitalization costs, and less frequent discharges to home compared to those without respiratory infections. In conclusion, respiratory infections significantly impact AMI admissions with higher rates of complications, mortality and resource utilization. |
| Databáze: | OpenAIRE |
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