Outcomes of percutaneous coronary intervention (PCI) among patients with connective tissue disease: Propensity match analysis

Int J Cardiol. 2020 Apr 1:304:29-34. doi: 10.1016/j.ijcard.2019.12.055. Epub 2020 Jan 9.

Abstract

Background: Inflammation is the hallmark of coronary artery disease (CAD) and CTD. There are reports of increased prevalence of CAD among patients with CTD such as Rheumatoid Arthritis. However, there is a paucity of data regarding the outcomes of PCI among patients with CTD.

Methods: Using the National Inpatient Database, patients that underwent PCI between 2007 and 2015 were identified using ICD-9-CM codes. Propensity match analysis with 1: 3 matching of patients with and without CTD was performed. Outcomes were acute kidney injury (AKI), access site complication (ASC), ventricular fibrillation (VF), cardiogenic shock (CS), Stroke, In-hospital mortality and hospital length of stay (LOS) compared between both groups.

Result: We identified 17,422 patients with CTD and matched with 52, 266 patients without CTD. Patients were predominantly female (63.1%) and white (77.2%), with a mean age of 63 ± 12.1 years. AKI (8.3% vs. 6.6%, p < 0.001), ASC (3.2% vs. 2.7%, p = 0.01) and hospital stay (4.2 ± 4.8 vs. 3.8 ± 5.2, p < 0.001) were higher among patients with CTD. There was no statistically significant difference in rates of VF, CS, stroke, and In-hospital mortality among the two groups. However, in subgroup analysis, rates of VF were lower among patients with Systemic Lupus Erythematosus (SLE) (1.5% vs. 2.2%, p = 0.006).

Conclusions: Patients with CTD undergoing PCI have a higher rate of AKI, Access site complications, and prolonged hospital stay.

Keywords: Access site complication (ASC); Acute kidney injury (AKI); Connective tissue disease (CTD); Percutaneous coronary intervention (PCI).

MeSH terms

  • Acute Kidney Injury*
  • Aged
  • Connective Tissue Diseases*
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / surgery
  • Female
  • Humans
  • Middle Aged
  • Percutaneous Coronary Intervention* / adverse effects
  • Risk Factors
  • Shock, Cardiogenic
  • Treatment Outcome