This article is more than 5 years old. Information may no longer be current.
AF confers risk for poor in-hospital outcomes after PCI
Click Here to Manage Email Alerts
Patients with a history of atrial fibrillation undergoing PCI display a higher risk for in-hospital complications such as bleeding, HF, cardiogenic shock and mortality, according to a study published in the Journal of the American College of Cardiology.
Nadia R. Sutton, MD, MPH, from the department of internal medicine, division of cardiovascular medicine, University of Michigan, Ann Arbor, and colleagues analyzed patients from a large, prospective multicenter registry to determine a link between AF and adverse in-hospital outcomes.
Nadia R. Sutton
The researchers evaluated data from 113,283 consecutive PCI cases from 47 hospitals between April 2011 and December 2014. Adjustments were made for differences in baseline characteristics between patients with and without a history of HF.
Sutton and colleagues found a history of AF in 12% of the study population, varying by institution (range, 2.5%-18.4%). Before propensity matching, patients with a history of AF vs. none were older (age, 72.1 years vs. 64.1 years) and were more likely to have comorbid congestive HF, cardiomyopathy, cerebrovascular disease and chronic lung disease.
In-hospital complications were more common in patients with a history of AF, including mortality (3.2% vs. 1.3%; P < .001).
When the researchers conducted propensity matching of 13,498 patients with AF and the same number without AF data, they determined those with a history of AF were more likely to be treated with a bare-metal stent (27.2% vs. 18.1%; P < .001).
In the propensity-matched cohort, AF was linked to a higher risk for postprocedural bleeding (OR = 1.32; 95% CI, 1.15-1.52), HF (OR = 1.33; 95% CI, 1.17-1.52), cardiogenic shock (OR = 1.26; 95% CI, 1.08-1.48) and mortality (OR = 1.41; 95% CI, 1.18-1.68).
“These findings indicate that a history of AF is a marker of patients who are vulnerable to serious in-hospital complications after PCI,” the researchers wrote. “It has been theorized that AF is a clinical manifestation of a fibrotic atrial cardiomyopathy that can occur independently of age and comorbidities. Whether AF drives this structural process or is a consequence is unclear.” – by James Clark
Disclosure: Sutton reports no relevant disclosures. One researcher reports consulting for Osprey Medical.
Click Here to Manage Email Alerts