TY - JOUR
T1 - Predictors of in-hospital mortality in coronary artery dissection
T2 - Findings from the National Inpatient Sample 2009–2010
AU - Garg, Jalaj
AU - Krishnamoorthy, Parasuram
AU - Palaniswamy, Chandrasekar
AU - Pandey, Ambarish
AU - Ahmad, Hasan
N1 - Publisher Copyright:
© 2015 Via Medica.
PY - 2015
Y1 - 2015
N2 - Background: The pathophysiology of coronary artery dissection (CD) remains poorly understood and little is known about the factors predicting mortality in these patients. We aimed to study the epidemiology of CD and predictors of mortality in these patients. Methods: All patients diagnosed with CD in the Nationwide Inpatient Sample 2009–2010 database using International Classification of Diseases ninth revision 414.12 were included in the study. Chronic conditions included in the analysis were diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease (CAD), obesity, alcohol use, smoking, heart failure and ventricular arrhythmias. Non-cardiovascular conditions were connective tissue disorders, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan’s syndrome, sarcoidosis, Crohn’s disease, polycystic kidney disease, rheumatoid arthritis, vasculitis including giant cell arteritis, polyarteritis nodosa and Takayasu’s disease, cocaine use, early or premature labor. Results: The prevalence of CD in the United States was 0.02% (n = 11,255), based on the hospital admissions reviewed in the database. The mean age was 63.25 years with women (64.62 years) being older than men (62.25 years) (p < 0.001). In-hospital mortality rate was 4.2%, with women (5.5%) having higher mortality than men (3.2%) (p = 0.009). Ventricular arrhythmias (OR 5.86, p < 0.001) predicted higher mortality, while hyperlipidemia (OR 0.26, p < 0.001) and CAD (OR 0.31, p = 0.001) predicted lower mortality in multivariate analysis. Conclusions: Our study demonstrated that CD was more prevalent in men but women had higher mortality than men. Age, heart failure and ventricular arrhythmias were independent predictors of increased mortality but hyperlipidemia CAD predicted lower mortality in patients with CD.
AB - Background: The pathophysiology of coronary artery dissection (CD) remains poorly understood and little is known about the factors predicting mortality in these patients. We aimed to study the epidemiology of CD and predictors of mortality in these patients. Methods: All patients diagnosed with CD in the Nationwide Inpatient Sample 2009–2010 database using International Classification of Diseases ninth revision 414.12 were included in the study. Chronic conditions included in the analysis were diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease (CAD), obesity, alcohol use, smoking, heart failure and ventricular arrhythmias. Non-cardiovascular conditions were connective tissue disorders, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan’s syndrome, sarcoidosis, Crohn’s disease, polycystic kidney disease, rheumatoid arthritis, vasculitis including giant cell arteritis, polyarteritis nodosa and Takayasu’s disease, cocaine use, early or premature labor. Results: The prevalence of CD in the United States was 0.02% (n = 11,255), based on the hospital admissions reviewed in the database. The mean age was 63.25 years with women (64.62 years) being older than men (62.25 years) (p < 0.001). In-hospital mortality rate was 4.2%, with women (5.5%) having higher mortality than men (3.2%) (p = 0.009). Ventricular arrhythmias (OR 5.86, p < 0.001) predicted higher mortality, while hyperlipidemia (OR 0.26, p < 0.001) and CAD (OR 0.31, p = 0.001) predicted lower mortality in multivariate analysis. Conclusions: Our study demonstrated that CD was more prevalent in men but women had higher mortality than men. Age, heart failure and ventricular arrhythmias were independent predictors of increased mortality but hyperlipidemia CAD predicted lower mortality in patients with CD.
KW - Arrhythmias
KW - Coronary artery dissection
KW - Predictors of mortality
KW - Risk factors
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U2 - 10.5603/CJ.a2014.0048
DO - 10.5603/CJ.a2014.0048
M3 - Article
C2 - 25002114
AN - SCOPUS:84928638792
SN - 1897-5593
VL - 22
SP - 135
EP - 140
JO - Cardiology Journal
JF - Cardiology Journal
IS - 2
ER -