Abstract 20332: Outcomes of Acute Myocardial Infarctions Complications in the United States
Introduction: Acute myocardial infarction complications are recognized as a major source of morbidity and mortality. However, there is paucity of data regarding hospitalization outcomes, epidemiology, and social implications of such complications.
Methods: Data was collected from the Nationwide Inpatient Sample (NIS) between 2001 and2012. Subjects were identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Stata IC 11.0 (Stata-Corp, College Station, TX) and SAS 9.3 (SAS Institute Inc, Cary, North Carolina) were utilized for statistical analyses.
Results: A total of 3,373,206 myocardial infarctions with acute complications were identified. Most patients were male (63.1%), Caucasian (60.8%), and 50 to 79 years old (65%). Most complications were equally reported in urban-teaching and non-teaching institutions throughout the US and the annual rate remained largely unchanged. Throughout these years, the use of drug eluting stents (DES) increased to a cumulative average of 19.7%. Overall mortality rate was 10.4%. The most common complications were mechanical (32.2%), conduction abnormalities (22%), mitral valve dysfunction (5.6%), and arrhythmias (ventricular tachycardia 7.9% and ventricular fibrillation 4.7%). Less frequent complications included inflammatory (3%), high-degree AV blocks (2.1%), embolization (0.3%), and cardiac rupture (0.2%). Mortality predictors included female sex (OR=1.11, 1.08-1.113, p<0.0001), mechanical (OR=2.35, 2.28-2.43, p<0.0001) and conduction complications (OR=1.63, 1.59-1.67, p<0.0001), posterior MI (OR=1.15, 1.04-1.27, p<0.0001), and in hospital cardiac arrest (OR=19.39, 18.46-20.35, p<0.0001). On a yearly basis, the rate of these complications and mortality did not change considerably.
Conclusions: Acute myocardial infarction complications constitute a major source of morbidity and mortality. Despite the multiple advances in the post-thrombolytic and PCI era, the rate of these complications remains significant. Perhaps, further research in this area will shed light on novel techniques and treatment modalities.
Author Disclosures: A. Rodriguez: None. V. Singh: None. B. Thakkar: None. V. Patel: None. A. Lekshminarayanan: None. P. Bhatt: None. M. Rivera Maza: None. R. Mendirichaga: None. V. Blume: None. C. Alfonso: None. M. Cohen: None.
- © 2016 by American Heart Association, Inc.