Outcomes of Acute Myocardial Infarction in Patients with Hypertrophic Cardiomyopathy - 23/07/15
, Marjan Mujib, MD, MPH a, Chandrasekar Palaniswamy, MD c, Sachin Sule, MD a, Diwakar Jain, MD b, Ali Ahmed, MD, MPH d, Gregg M. Lanier, MD b, Howard A. Cooper, MD b, William H. Frishman, MD b, Gregg C. Fonarow, MD e, Julio A. Panza, MD bAbstract |
Background |
Acute myocardial infarction is a recognized complication in patients with hypertrophic cardiomyopathy. However, limited data are available on outcomes of patients with hypertrophic cardiomyopathy and acute myocardial infarction.
Methods |
We analyzed the 2003-2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years with a principal diagnosis of acute myocardial infarction. Patients with a concomitant diagnosis of hypertrophic cardiomyopathy were then identified and analyzed as a separate cohort. Multivariate logistic regression was used to compare outcomes in patients with acute myocardial infarction with and without hypertrophic cardiomyopathy.
Results |
Of 5,901,827 patients with acute myocardial infarction, 5688 (0.1%) had a diagnosis of hypertrophic cardiomyopathy. Patients with hypertrophic cardiomyopathy were older, more likely to be female, and less likely to have traditional cardiovascular risk factors. Compared with patients without hypertrophic cardiomyopathy, patients with hypertrophic cardiomyopathy were less likely to present with ST-elevation myocardial infarction and more likely to present with non-ST-elevation myocardial infarction. Patients with hypertrophic cardiomyopathy with ST-elevation myocardial infarction or non-ST-elevation myocardial infarction were less likely to receive revascularization. In the overall population with acute myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with and without hypertrophic cardiomyopathy (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.84-1.11; P = .59). In the population with ST-elevation myocardial infarction, patients with hypertrophic cardiomyopathy had lower risk-adjusted in-hospital mortality than those without hypertrophic cardiomyopathy (OR, 0.75; 95% CI, 0.63-0.91; P = .003), whereas in the population with non–ST-elevation myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with and without hypertrophic cardiomyopathy (OR, 0.97; 95% CI, 0.84-1.11; P = .63).
Conclusions |
Patients with hypertrophic cardiomyopathy represent a small proportion of patients with acute myocardial infarction and are less likely to receive revascularization. Compared with patients without hypertrophic cardiomyopathy, patients with hypertrophic cardiomyopathy with ST-elevation myocardial infarction have lower risk-adjusted in-hospital mortality.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Acute myocardial infarction, Hypertrophic cardiomyopathy, In-hospital mortality, Revascularization
Mappa
| Funding: None. |
|
| Conflict of Interest: None. |
|
| Authorship: All authors had access to the data and played a role in writing this manuscript. |
|
| TG, PH, DK, and SK have contributed equally to this study. |
|
| Part of this study was presented at: the American College of Cardiology 64th Scientific Sessions, March 15, 2015, San Diego, California. |
Vol 128 - N° 8
P. 879 - agosto 2015 Ritorno al numero
Articolo precedente
- Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease
- James K. Min, Allison Dunning, Heidi Gransar, Stephan Achenbach, Fay Y. Lin, Mouaz Al-Mallah, Matthew J. Budoff, Tracy Q. Callister, Hyuk-Jae Chang, Filippo Cademartiri, Erica Maffei, Kavitha Chinnaiyan, Benjamin J.W. Chow, Ralph D'Agostino, Augustin DeLago, John Friedman, Martin Hadamitzky, Joerg Hausleiter, Sean W. Hayes, Philipp Kaufmann, Gilbert L. Raff, Leslee J. Shaw, Louise Thomson, Todd Villines, Ricardo C. Cury, Gudrun Feuchtner, Yong-Jin Kim, Jonathon Leipsic, Hugo Marques, Daniel S. Berman, Michael Pencina
- Prevention of Knee Osteoarthritis in Overweight Females: The First Preventive Randomized Controlled Trial in Osteoarthritis
- Jos Runhaar, Marienke van Middelkoop, Max Reijman, Sten Willemsen, Edwin H. Oei, Dammis Vroegindeweij, Gerjo van Osch, Bart Koes, Sita M.A. Bierma-Zeinstra
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?