Mechanical Complications in ST-Elevation Myocardial Infarction (STEMI) Based on Different Reperfusion Strategies
Contemporary trends of mechanical complications like papillary muscle rupture (PMR), ventricular septal defect/rupture (VSR), and free wall rupture (FWR) in ST-elevation m'yocardial infarction (STEMI), especially in the era of primary percutaneous coronary interventions (PPCI) has not been defi...
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Veröffentlicht in: | The American journal of cardiology 2021-10, Vol.156, p.79-84 |
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description | Contemporary trends of mechanical complications like papillary muscle rupture (PMR), ventricular septal defect/rupture (VSR), and free wall rupture (FWR) in ST-elevation m'yocardial infarction (STEMI), especially in the era of primary percutaneous coronary interventions (PPCI) has not been definitively investigated. We utilized the National Inpatient Sample (NIS) database from years 2003 to 2017 using International Classification of Disease 9th and 10th revision (ICD-9 and ICD-10) codes to identify STEMI patients undergoing PPCI, fibrinolysis alone, and fibrinolysis with subsequent PCI. We identified those developing in-hospital PMR /VSD / FWR. We identified a total of 2,034,153 STEMI patients where 93.5% had PPCI, 3.2% had fibrinolysis alone, and 3.3% had fibrinolysis with subsequent PCI. Rates of all mechanical complications was low for all three different reperfusion strategies evaluated, with downward trends (p |
doi_str_mv | 10.1016/j.amjcard.2021.06.012 |
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We utilized the National Inpatient Sample (NIS) database from years 2003 to 2017 using International Classification of Disease 9th and 10th revision (ICD-9 and ICD-10) codes to identify STEMI patients undergoing PPCI, fibrinolysis alone, and fibrinolysis with subsequent PCI. We identified those developing in-hospital PMR /VSD / FWR. We identified a total of 2,034,153 STEMI patients where 93.5% had PPCI, 3.2% had fibrinolysis alone, and 3.3% had fibrinolysis with subsequent PCI. Rates of all mechanical complications was low for all three different reperfusion strategies evaluated, with downward trends (p <0.05) over time. No statistically significant difference in the rates of mechanical complication was noted among patients treated with different reperfusion strategies on multivariable logistic regression models. In conclusion, in a contemporary cohort of US patients-majority of whom were managed with PPCI, the rates of overall mechanical complications after STEMI were low even with initial use of fibrinolytics and exhibited a downward temporal trend.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2021.06.012</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Anemia ; Cardiac arrhythmia ; Cardiovascular disease ; Chronic obstructive pulmonary disease ; Codes ; Complications ; Coronary vessels ; Family income ; Fibrinolysis ; Health care policy ; Heart attacks ; Hospitalization ; Hypertension ; Medicare ; Mortality ; Muscles ; Myocardial infarction ; Pandemics ; Patients ; Regression analysis ; Regression models ; Reperfusion ; Rupture ; Rupturing ; Statistical analysis ; Teaching hospitals ; Trends ; Ventricle</subject><ispartof>The American journal of cardiology, 2021-10, Vol.156, p.79-84</ispartof><rights>2021 Elsevier Inc.</rights><rights>2021. 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We utilized the National Inpatient Sample (NIS) database from years 2003 to 2017 using International Classification of Disease 9th and 10th revision (ICD-9 and ICD-10) codes to identify STEMI patients undergoing PPCI, fibrinolysis alone, and fibrinolysis with subsequent PCI. We identified those developing in-hospital PMR /VSD / FWR. We identified a total of 2,034,153 STEMI patients where 93.5% had PPCI, 3.2% had fibrinolysis alone, and 3.3% had fibrinolysis with subsequent PCI. Rates of all mechanical complications was low for all three different reperfusion strategies evaluated, with downward trends (p <0.05) over time. No statistically significant difference in the rates of mechanical complication was noted among patients treated with different reperfusion strategies on multivariable logistic regression models. In conclusion, in a contemporary cohort of US patients-majority of whom were managed with PPCI, the rates of overall mechanical complications after STEMI were low even with initial use of fibrinolytics and exhibited a downward temporal trend.</description><subject>Anemia</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Codes</subject><subject>Complications</subject><subject>Coronary vessels</subject><subject>Family income</subject><subject>Fibrinolysis</subject><subject>Health care policy</subject><subject>Heart attacks</subject><subject>Hospitalization</subject><subject>Hypertension</subject><subject>Medicare</subject><subject>Mortality</subject><subject>Muscles</subject><subject>Myocardial infarction</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Reperfusion</subject><subject>Rupture</subject><subject>Rupturing</subject><subject>Statistical analysis</subject><subject>Teaching hospitals</subject><subject>Trends</subject><subject>Ventricle</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU1LAzEQhoMoWD9-grDgpR52TbJJ2pxEa9WCRbD1HNJkolm2u2uyFfz3pq0nL55m5uWZL16ELgguCCbiuir0ujI62IJiSgosCkzoARqQ8UjmRJLyEA0wxjSXhMljdBJjlUpCuBigbg7mQzfe6DqbtOuuTlnv2yZmvskWy3xaw9dOyObf7XaHT-CscTqYnTpcLKfz2VV2pyPYLAn33jkI0PTZK3QQ3CZusUUfdA_vHuIZOnK6jnD-G0_R28N0OXnKn18eZ5Pb59yUI9znQmhrBOOG8ZXlTuIRNZwxaq2gusR2tWIESydGhmgnGeZjLEvrtHPGWOJseYqG-7ldaD83EHu19tFAXesG2k1UlHMuGJUlT-jlH7RqN6FJ1yVKjCmjjJSJ4nvKhDbGAE51wa91-FYEq60PqlK_PqitDwoLlXxIfTf7PkjffnkIKhoPjQHrA5he2db_M-EHJHGT8g</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Tripathi, Byomesh</creator><creator>Aggarwal, Vikas</creator><creator>Abbott, Jinnette Dawn</creator><creator>Kumbhani, Dharam J</creator><creator>Giri, Jay</creator><creator>Kalra, Ankur</creator><creator>Sardar, Partha</creator><creator>Chatterjee, Saurav</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20211001</creationdate><title>Mechanical Complications in ST-Elevation Myocardial Infarction (STEMI) Based on Different Reperfusion Strategies</title><author>Tripathi, Byomesh ; 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We utilized the National Inpatient Sample (NIS) database from years 2003 to 2017 using International Classification of Disease 9th and 10th revision (ICD-9 and ICD-10) codes to identify STEMI patients undergoing PPCI, fibrinolysis alone, and fibrinolysis with subsequent PCI. We identified those developing in-hospital PMR /VSD / FWR. We identified a total of 2,034,153 STEMI patients where 93.5% had PPCI, 3.2% had fibrinolysis alone, and 3.3% had fibrinolysis with subsequent PCI. Rates of all mechanical complications was low for all three different reperfusion strategies evaluated, with downward trends (p <0.05) over time. No statistically significant difference in the rates of mechanical complication was noted among patients treated with different reperfusion strategies on multivariable logistic regression models. In conclusion, in a contemporary cohort of US patients-majority of whom were managed with PPCI, the rates of overall mechanical complications after STEMI were low even with initial use of fibrinolytics and exhibited a downward temporal trend.</abstract><cop>New York</cop><pub>Elsevier Inc</pub><doi>10.1016/j.amjcard.2021.06.012</doi><tpages>6</tpages></addata></record> |
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subjects | Anemia Cardiac arrhythmia Cardiovascular disease Chronic obstructive pulmonary disease Codes Complications Coronary vessels Family income Fibrinolysis Health care policy Heart attacks Hospitalization Hypertension Medicare Mortality Muscles Myocardial infarction Pandemics Patients Regression analysis Regression models Reperfusion Rupture Rupturing Statistical analysis Teaching hospitals Trends Ventricle |
title | Mechanical Complications in ST-Elevation Myocardial Infarction (STEMI) Based on Different Reperfusion Strategies |
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