scholarly journals Association of acute myocardial infarction cardiac arrest patient volume and in-hospital mortality in the United States: Insights from the National Cardiovascular Data Registry Acute Coronary Treatment And Intervention Outcomes Network Registry

2019 ◽  
Vol 42 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Michael C. Kontos ◽  
Christopher B. Fordyce ◽  
Anita Y. Chen ◽  
Karen Chiswell ◽  
Jonathan R. Enriquez ◽  
...  
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
The United States ◽  
Cardiac Arrest Patient ◽  
Patient Volume ◽  
Data Registry ◽  
National Cardiovascular

Abstract 14703: Sex Disparities in Management and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Dhiran Verghese ◽  
Sri Harsha Patlolla ◽  
Saraschandra Vallabhajosyula
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
The United States ◽  
Circulatory Support ◽  
Multivariable Logistic Regression Analysis ◽  
Shockable Rhythm ◽  
Sex Disparities

Background: Sex disparities exist in acute cardiovascular care. Despite sex-specific cardiac arrest (CA) research being identified as a priority by professional societies, there are limited studies on this topic. Objectives: To assess sex disparities in management and outcomes of CA complicating acute myocardial infarction (AMI) in a contemporary United States population. Methods: Adult admissions with a primary diagnosis of AMI and concomitant diagnosis of CA were identified using the National Inpatient Sample. Outcomes of interest included sex disparities in in-hospital mortality, coronary angiography (CAG), percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS) use. Results: Between January 1, 2000 and December 31, 2017, 11,622,528 admissions for AMI were identified, of which 584,216 (5.0%) were complicated by CA. Men had higher prevalence of CA compared to women (5.4% vs 4.4%, p< 0.001) in both STEMI and NSTEMI (2017 vs 2000, STEMI-men: 12.3% vs 7.8%, STEMI-women: 10.4% vs 7.5%, NSTEMI-men: 3.1% vs 2.7%, NSTEMI-women: 2.4% vs 2.5%). Women with AMI-CA were on average older (70.4 vs 65.0, p<0.001), of black race (12.6% vs 7.9%, p<0.001) and had higher comorbidity. Women were more likely to present with NSTEMI (36.4% vs 32.3%, p<0.001) and a non-shockable rhythm (47.6% vs 33.3%, p<0.001). Women less frequently received CAG (56.0% vs 66.2 %), early CAG (32.0% vs 40.2%), PCI (40.4% vs 49.7%), MCS (17.6% vs 22.0%), and CABG (all p<0.001). Women had significantly higher unadjusted in-hospital mortality (52.6% vs 40.6%, p < 0.001). In a multivariable logistic regression analysis, female sex was associated with higher in-hospital mortality (OR 1.13 [95% CI 1.11-1.14]; p< 0.001). When stratified by type of rhythm, type of AMI, presence of cardiogenic shock and location of CA, women consistently received less frequent CAG and experienced higher in-hospital mortality. Conclusion: In the largest 18-year study evaluating management and outcomes of CA in AMI, we identified the presence of significant sex disparities. Women with AMI-CA were older, with higher rates of non-shockable rhythm, were less likely to undergo therapeutic procedures including CAG, PCI, and MCS. Women had higher unadjusted and adjusted in-hospital mortality.

scholarly journals ASSOCIATION OF ACUTE MYOCARDIAL INFARCTION CARDIAC ARREST PATIENT VOLUME AND IN-HOSPITAL MORTALITY

2016 ◽  
Vol 67 (13) ◽  
pp. 567
Author(s):  
Michael C. Kontos ◽  
Christopher Fordyce ◽  
Jonathan Enriquez ◽  
Matthew Roe ◽  
Karen Chiswell ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Cardiac Arrest Patient ◽  
Patient Volume

Seasonal variation in the management and outcomes of cardiac arrest complicating acute myocardial infarction

QJM ◽  
2021 ◽  
Author(s):  
S H Patlolla ◽  
A Kanwar ◽  
P R Sundaragiri ◽  
W Cheungpasitporn ◽  
R P Doshi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Hospital Length Of Stay ◽  
Discharge Disposition ◽  
Hospitalization Costs

Summary Background There are limited data on the influence of seasons on the outcomes of acute myocardial infarction-cardiac arrest (AMI-CA). Aim To evaluate the outcomes of AMI-CA by seasons in the United States Design Retrospective cohort study Methods Using the National Inpatient Sample from 2000 to 2017, adult (&gt;18 years) admissions with AMI-CA were identified. Seasons were defined by the month of admission as spring, summer, fall and winter. The outcomes of interest were prevalence of AMI-CA, in-hospital mortality, use of coronary angiography, percutaneous coronary intervention (PCI), hospital length of stay, hospitalization costs and discharge disposition. Results Of the 10 880 856 AMI admissions, 546 334 (5.0%) were complicated by CA, with a higher prevalence in fall and winter (5.1% each) compared to summer (5.0%) and spring (4.9%). Baseline characteristics of AMI-CA admissions admitted in various seasons were largely similar. Compared to AMI-CA admissions in spring, summer and fall, AMI-CA admissions in winter had slightly lower rates of coronary angiography (63.3–64.3% vs. 61.4%) and PCI (47.2–48.4% vs. 45.6%). Compared to those admitted in the spring, adjusted in-hospital mortality was higher for winter {46.8% vs. 44.2%; odds ratio (OR) 1.08 [95% confidence interval (CI) 1.06–1.10]; P &lt; 0.001}, lower for summer [43% vs. 44.2%; OR 0.97 (95% CI 0.95–0.98); P &lt; 0.001] and comparable for fall [44.4% vs. 44.2%; OR 1.01 (95% CI 0.99–1.03); P = 0.31] AMI-CA admissions. Length of hospital stay, total hospitalization charges and discharge dispositions for AMI-CA admissions were comparable across the seasons. Conclusions AMI-CA admissions in the winter were associated with lower rates of coronary angiography and PCI, and higher rates of in-hospital mortality compared to the other seasons.

scholarly journals Gender Differences in In-Hospital Mortality Rates among Hispanic Patients with Acute Myocardial Infarction

2017 ◽  
Vol 4 (r) ◽  
Author(s):  
Nawaf Ebrahim Al-Jeraisy ◽  
Abdullah M. Al-Sultan ◽  
Sami A. Aldaham
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Death ◽  
P Value ◽  
Factors Associated ◽  
Hispanic Patients

Acute myocardial infarction (AMI) is a leading cause of death in the United States with over three million cases per year. Since the mid-1970s, the total number of deaths related to AMI in the United States has not declined. Studies suggest that women with AMI have worse outcomes compared to men. However, there is limited information regarding this topic among Hispanics. This study was a secondary analysis of the Puerto Rican Heart Attack Study, which reviewed the records of Hispanic patients of Puerto Rico hospitalized for AMI at 21 academic and/or non-teaching hospitals in 2007, 2009 and 2011. This study set examined the differences in in-hospital mortality rates between genders. A p-value of 0.2 was used to select possible confounders and the chi-square test was used to examine associations between categorical variables. Factors associated with in-hospital mortality rates were identified using logistic regression. Collinearity was assessed using Pearson correlation coefficients. The 95% confidence interval and a p-value of 0.05 were used to determine statistical significance of odds ratios. Analysis was restricted to patients with ICD-9-CM code 410-414 who are above 18 (n = 2265). In our sample, there were more men than women (1291 versus 974, respectively). Men were younger and smoked more compared to women. Compared to men, women were older and suffered more comorbidities, such as stroke and congestive heart failure (CHF). Women had higher rates of in-hospital mortality compared to men (OR = 1.4, p = 0.040). Factors associated with higher rates of in-hospital mortality included age and CHF (p<0.001). Patients with CHF showed higher rates of in-hospital deaths compared to patients who did not have CHF (OR = 1.6, p = 0.026). Patients over the age of 86 showed higher odds of in-hospital death compared to younger patients (OR = 10.5, p <0.001) Significant disparities existed by gender in this sample of Hispanic AMI patients, with women showing higher in-hospital mortality compared to men. Women over 50 should perform regular checkups and discuss hormone replacement therapy or follow other preventive measures as suggested by their healthcare provider.

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