Cardiovascular outcomes of patients with atrial fibrillation and concomitant cardiac amyloidosis undergoing percutaneous catheter ablation.

IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Garba Rimamskep Shamaki, Siva Neppala, Sinda Hidri, Priya Hotwani, Mohammed Aldabagh, Sundal Aziz, Prakash Upreti, Amith Seri, Dilesha Dilangi Kumanayaka, Ebenezer Oloyede, Yasar Sattar
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引用次数: 0

Abstract

Background: Atrial fibrillation has been linked with poor outcomes in patients with cardiac amyloidosis. We evaluate the in-hospital outcomes of patients with atrial fibrillation and concomitant cardiac amyloidosis with and without catheter ablation.

Methods: The National Inpatient Sample databases (2016 to 2021) were queried to identify patients admitted with atrial fibrillation and concomitant cardiac amyloidosis using ICD 10 codes. The study population aged >18 years was divided into two cohorts; ablation (AB) vs. no ablation (NAB). Multivariate logistic regression model adjusting for baseline characteristics and comorbidities. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were acute heart failure, cardiogenic shock, ventricular fibrillation, major bleeding, stroke, length of stay, and hospitalization cost.

Results: 73,160 patients were identified. 595(0.8 %) underwent ablation and 72,656 (99.2 %) did not. Both NAB and AB patients were predominantly white (69.6 % and 60.3 %) respectively. AB patients were younger with median age [74 years (IQR 66-80) vs. 78 years (IQR 71-84), p < 0.01], compared with NAB patients. AB patients were more likely to have heart failure (76.5 % vs. 65.3 %, p = 0.04), and have a family history of CAD (11.1 % vs. 4.8 %, p = 0.03). Contrarily, NAB patients were more likely to have dementia (11.5 % vs. 2.5 %, p = 0.01). After adjusting for baseline characteristics and comorbidity, there was no difference in all-cause mortality (OR 0.3, CI 0.08-1.35, p = 0.12), stroke (OR 1.1, CI 0.4-2.8, p = 0.87), or major bleeding (OR 1.4, CI 0.7-2.6, p = 0.37). Undergoing ablation was associated with higher odds of acute heart failure (OR 1.9, CI 1.1-3.3, p<0.01). After adjusting for inflation using the consumer price index, adjusted total cost of hospitalization was for higher AB patients was compared to NAB patients ($41,499.22 vs. $13,085.11) with a significantly longer length of stay among AB patients (7 days vs. 5days, p < 0.01).

Conclusion: Atrial fibrillation and concomitant cardiac amyloidosis in patients undergoing catheter ablation are associated with an increased risk of acute heart failure, higher cost, and a longer length of stay.

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来源期刊
Current Problems in Cardiology
Current Problems in Cardiology 医学-心血管系统
CiteScore
4.80
自引率
2.40%
发文量
392
审稿时长
6 days
期刊介绍: Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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