■浸润性疾病(ID),包括淀粉样变性,结节病,和血色素沉着病,以多个器官的异常细胞浸润为特征,包括心脏。经皮冠状动脉介入治疗(PCI)患者的预后尚未得到充分研究。我们评估了接受PCI的患者中ID的患病率及其与PCI后预后的关系。
■国家住院患者样本(NIS)2016-2020数据库用于识别具有ICD-10代码的PCI患者,以进行回顾性分析。然后将PCI患者分为有和没有基础ID的患者,其中包括淀粉样变性,结节病,和血色素沉着症。多变量逻辑回归分析用于PCI术后综合结局分析。
■在2,360,860例接受PCI的患者中,7855例患者有潜在的ID。结节病患病率最高(0.2%),其次是血色素沉着病(0.07%)和淀粉样变性(0.04%)。潜在淀粉样变性与PCI术后更差的复合结局相关(比值比[OR],1.6;95%CI,1.1-2.44;P=0.02),包括更高的住院死亡率(或,1.9;95%CI,1.1-3.4;P=0.04),PCI术中/术后卒中的风险更高(OR,4.0;95%CI,1.1-16.0;P=0.04),但不是大出血(或,2.2;95%CI,0.97-5.03;P=.058)。相比之下,潜在结节病(OR,1.1;95%CI,0.87-1.41;P=4),和血色素沉着病(OR,1.18;95%CI,0.77-1.8;P=.44)与PCI后复合结局无关。接受PCI的淀粉样变性患者的住院费用也较高(212,123美元vs141,137美元;P=.03),住院时间更长(8.2vs3.9天;P<.001)。
潜在的淀粉样变性与PCI术后更差的结局相关,包括更高的院内死亡率。PCI内/后卒中,和社会经济负担。需要多学科方法和未来的研究来研究这些患者的筛查和治疗策略。
UNASSIGNED: Infiltrative diseases (IDs), including amyloidosis, sarcoidosis, and
hemochromatosis, are characterized by abnormal cellular infiltration in multiple organs, including the heart. The prognosis of percutaneous coronary intervention (PCI) patients with underlying IDs has not been well-studied. We evaluated the prevalence of IDs in patients undergoing PCI and their association with post-PCI outcomes.
UNASSIGNED: The National Inpatient Sample (NIS) 2016-2020 database was used to identify PCI patients with ICD-10 codes for a retrospective analysis. PCI patients were then divided into those with and without underlying IDs, which included amyloidosis, sarcoidosis, and
hemochromatosis. Multivariable logistic regression was performed for composite post-PCI outcomes analyses.
UNASSIGNED: Among 2,360,860 patients admitted to undergo PCI, 7855 patients had underlying IDs. The highest prevalence was observed for sarcoidosis (0.2%) followed by
hemochromatosis (0.07%) and amyloidosis (0.04%). Underlying amyloidosis was associated with worse composite post-PCI outcomes (odds ratio [OR], 1.6; 95% CI, 1.1-2.44; P = .02), including higher in-hospital mortality (OR, 1.9; 95% CI, 1.1-3.4; P = .04), higher risk of intra/post-PCI stroke (OR, 4.0; 95% CI, 1.1-16.0; P = .04), but not major bleeding (OR, 2.2; 95% CI, 0.97-5.03; P = .058). In contrast, underlying sarcoidosis (OR, 1.1; 95% CI, 0.87-1.41; P = .4), and
hemochromatosis (OR, 1.18; 95% CI, 0.77-1.8; P = .44) were not associated with composite post-PCI outcomes. Amyloidosis patients undergoing PCI also had higher hospitalization charges ($212,123 vs $141,137; P = .03) and longer length of stay (8.2 vs 3.9 days; P < .001).
UNASSIGNED: Underlying amyloidosis was associated with worse post-PCI outcomes including higher in-hospital mortality, intra/post-PCI stroke, and socioeconomic burden. A multidisciplinary approach and future studies are needed to investigate the screening and treatment strategies in these patients.