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Percutaneous Coronary Intervention Outcomes Based on Decision‐Making Capacity

Authors :
Beni R Verma
Saket Saxena
Stephen G. Ellis
Jarmanjeet Singh
Venu Menon
Chirag C. Sheth
Samir R. Kapadia
Amar Krishnaswamy
Keerat Rai Ahuja
Nicholas Kassis
Jaikirshan Khatri
Source :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 17 (2021)
Publication Year :
2021
Publisher :
John Wiley and Sons Inc., 2021.

Abstract

BackgroundLong‐term outcomes of percutaneous coronary intervention (PCI) based on patients’ decision‐making ability have not been studied. Our objective was to assess long‐term outcomes after PCI in patients who provided individual versus surrogate consent.Methods and ResultsData were collected retrospectively for patients who underwent PCI at Cleveland Clinic between January 1, 2015 and December 31, 2016. Inclusion criteria consisted of hospitalized patients aged ≥20 years who had PCI. Patients with outpatient PCI, or major surgery 30 days before or 90 days after PCI, were excluded. Patients who underwent PCI with surrogate consent versus individual consent were matched using the propensity analysis. Kaplan–Meier, log rank,t‐statistic, and χ2tests were used for statistical analysis. The study was approved by the Institutional Review Board at Cleveland Clinic, Ohio. Of 3136 patients who underwent PCI during the study period, 183 had surrogate consent. Propensity matching yielded 149 patients from each group. Two‐year all‐cause mortality was significantly higher in the surrogate consent group (38 [25.5%] versus 16 [10.7%] deaths, log‐rankχ2=10.16,Pχ2=8.36,P=0.003).ConclusionsPatients with surrogate consent had significantly higher all‐cause mortality and higher major adverse cardiac events when compared with patients with individual consent. This study emphasizes the fact that patients with an inability to give consent are at high risk and may need special attention in postprocedural and postdischarge care.

Details

Language :
English
ISSN :
20479980
Volume :
10
Issue :
17
Database :
OpenAIRE
Journal :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Accession number :
edsair.doi.dedup.....2382b848b221b033f5e7032de28ca501