1. Temporal trends in prevalence and outcomes of atrial fibrillation in patients undergoing percutaneous coronary intervention.
- Author
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Morita Y, Hamaguchi T, Yamaji Y, Hayashi H, Nakane E, Haruna Y, Haruna T, Hanyu M, and Inoko M
- Subjects
- Aged, Aged, 80 and over, Anticoagulants therapeutic use, Atrial Fibrillation complications, Atrial Fibrillation mortality, Comorbidity, Coronary Disease complications, Coronary Disease mortality, Databases, Factual, Female, Health Care Costs statistics & numerical data, Health Care Costs trends, Health Resources statistics & numerical data, Health Resources trends, Hospital Mortality trends, Hospitalization economics, Hospitalization statistics & numerical data, Hospitalization trends, Humans, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Percutaneous Coronary Intervention trends, Prevalence, Propensity Score, Time Factors, Treatment Outcome, United States epidemiology, Atrial Fibrillation epidemiology, Coronary Disease epidemiology, Coronary Disease surgery, Percutaneous Coronary Intervention statistics & numerical data
- Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing percutaneous coronary intervention (PCI)., Hypothesis: Large administrative data may provide further insight into temporal trends in the prevalence and burden of AF in patients who underwent PCI., Methods: Using the National Inpatient Sample database in the U.S., AF patients ≥18 years who underwent PCI between 2005 and 2014 and were identified by the International Classification of Diseases, ninth revision, Clinical Modification, were examined. In-hospital mortality, morbidity, resource use, and medical costs were evaluated in crude and propensity-matched analyses., Results: Among an estimated 6 272 232 hospitalizations, of patients undergoing PCI, AF prevalence was 9.9% and steadily increased from 8.6% to 12.0% between 2005 and 2014 (P < .001); there was also a greater proportion of comorbidities. There was a marked increase in AF prevalence among those aged ≥65 years and those undergoing elective PCIs. AF was independently associated with higher in-hospital mortality and higher rates of transient ischaemic attack/stroke, bleeding complications, and non-home discharge. Excessive in-hospital mortality, stroke rate, gastrointestinal bleeding, blood transfusion, length of stay, and costs among AF hospitalizations were consistently observed throughout the study period., Conclusion: AF becomes more prevalent in patients undergoing PCI, possibly due to a higher comorbidity, particularly in elderly patients with non-acute indications. Less favorable trends in mortality, bleeding, and stroke among AF patients who underwent PCI were consistent over time. Continuous efforts are needed to improve outcomes and manage strategies for AF patients undergoing PCI., (© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.)
- Published
- 2020
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