Outcomes among patients with non-ST-elevation myocardial infarction on chronic anticoagulation: Insights from the National Inpatient Sample.
Catheter Cardiovasc Interv
; 2024 Aug 27.
Article
em En
| MEDLINE
| ID: mdl-39189059
ABSTRACT
BACKGROUND:
Chronic systemic anticoagulation use is prevalent for various thromboembolic conditions. Anticoagulation (usually through heparin products) is also recommended for the initial management of non-ST-elevation myocardial infarction (NSTEMI).AIMS:
To evaluate the in-hospital outcomes of patients with NSTEMI who have been on chronic anticoagulation.METHODS:
Using the National Inpatient Sample (NIS) years 2016-2020, NSTEMI patients and patients with chronic anticoagulation were identified using the appropriate International Classification of Diseases, 10th version (ICD-10) appropriate codes. The primary outcome was all-cause in-hospital mortality while the secondary outcomes included major bleeding, ischemic cerebrovascular accident (CVA), early percutaneous coronary intervention (PCI) (i.e., within 24 h of admission), coronary artery bypass graft (CABG) during hospitalization, length of stay (LOS), and total charges. Multivariate logistic or linear regression analyses were performed after adjusting for patient-level and hospital-level factors.RESULTS:
Among 2,251,914 adult patients with NSTEMI, 190,540 (8.5%) were on chronic anticoagulation. Chronic anticoagulation use was associated with a lower incidence of in-hospital mortality (adjusted odds ratio [aOR] 0.69, 95% confidence interval [CI] 0.65-0.73, p < 0.001). There was no significant difference in major bleeding (aOR 0.95, 95% CI 0.88-1.0, p = 0.15) or ischemic CVA (aOR 0.23, 95% CI 0.03-1.69, p = 0.15). Chronic anticoagulation use was associated with a lower incidence of early PCI (aOR 0.78, 95% CI 0.76-0.80, p < 0.001) and CABG (aOR 0.43, 95% CI 0.41-0.45, p < 0.001). Chronic anticoagulation was also associated with decreased LOS and total charges (adjusted mean difference [aMD] -0.8 days, 95% CI -0.86 to -0.75, p < 0.001) and (aMD $-19,340, 95% CI -20,692 to -17,988, p < 0.001).CONCLUSIONS:
Among patients admitted with NSTEMI, chronic anticoagulation use was associated with lower in-hospital mortality, LOS, and total charges, with no difference in the incidence of major bleeding.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos