Akshay Machanahalli Balakrishna, Mahmoud Ismayl, D. Butt, F. Niu, Azka Latif, A. Arouni
{"title":"Trends, outcomes, and management of acute myocardial infarction in patients with chronic viral hepatitis","authors":"Akshay Machanahalli Balakrishna, Mahmoud Ismayl, D. Butt, F. Niu, Azka Latif, A. Arouni","doi":"10.1080/21548331.2022.2072314","DOIUrl":null,"url":null,"abstract":"ABSTRACT Objectives There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI). Methods We utilized the National Inpatient Sample database (2001–2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression. Results Of 18,794,686 AMI admissions, 84,147 (0.45%) had a CVH diagnosis. CVH patients had increased odds of adverse outcomes including in-hospital mortality (aOR 1.40, 95%CI 1.31–1.49, p < 0.05), respiratory failure (1.11, 95%CI 1.04–1.17, p < 0.001), vascular complications (1.09, 95%CI 1.04–1.15, p < 0.001), acute kidney injury (1.36, 95%CI 1.30–1.42, p < 0.001), gastrointestinal bleeding (1.57, 95%CI 1.50–1.68, p < 0.001), cardiogenic shock (1.44, 95%CI 1.04–1.30, p < 0.001), sepsis (1.24, 95%CI 1.17–1.31, p < 0.001), and were less likely to undergo invasive management. On subgroup analysis, CHB had higher odds of adverse outcomes than the CHC group (p < 0.05). Conclusion CVH patients presenting with AMI are associated with worse clinical outcomes. CHB subgroup had worse outcomes compared to the CHC subgroup.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"236 - 243"},"PeriodicalIF":0.0000,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hospital practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/21548331.2022.2072314","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
ABSTRACT Objectives There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI). Methods We utilized the National Inpatient Sample database (2001–2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression. Results Of 18,794,686 AMI admissions, 84,147 (0.45%) had a CVH diagnosis. CVH patients had increased odds of adverse outcomes including in-hospital mortality (aOR 1.40, 95%CI 1.31–1.49, p < 0.05), respiratory failure (1.11, 95%CI 1.04–1.17, p < 0.001), vascular complications (1.09, 95%CI 1.04–1.15, p < 0.001), acute kidney injury (1.36, 95%CI 1.30–1.42, p < 0.001), gastrointestinal bleeding (1.57, 95%CI 1.50–1.68, p < 0.001), cardiogenic shock (1.44, 95%CI 1.04–1.30, p < 0.001), sepsis (1.24, 95%CI 1.17–1.31, p < 0.001), and were less likely to undergo invasive management. On subgroup analysis, CHB had higher odds of adverse outcomes than the CHC group (p < 0.05). Conclusion CVH patients presenting with AMI are associated with worse clinical outcomes. CHB subgroup had worse outcomes compared to the CHC subgroup.
目前关于慢性病毒性肝炎(CVH)患者(包括慢性乙型肝炎(CHB)和慢性丙型肝炎(CHC))急性心肌梗死(AMI)的治疗和预后的数据缺乏。方法利用全国住院患者样本数据库(2001-2019),研究CVH合并AMI患者的管理和结局,并按CVH亚型进行分层。采用多变量logistic回归比较CVH组与无CVH组不良结局的校正优势比(aOR)。结果18,794,686例AMI患者中,有84,147例(0.45%)诊断为CVH。CVH患者不良结局发生率增加,包括院内死亡(aOR 1.40, 95%CI 1.31-1.49, p < 0.05)、呼吸衰竭(aOR 1.11, 95%CI 1.04-1.17, p < 0.001)、血管并发症(1.09,95%CI 1.04-1.15, p < 0.001)、急性肾损伤(1.36,95%CI 1.30-1.42, p < 0.001)、胃肠道出血(1.57,95%CI 1.50-1.68, p < 0.001)、心源性休克(1.44,95%CI 1.04-1.30, p < 0.001)、脓毒症(1.24,95%CI 1.17-1.31, p < 0.001)、也不太可能接受侵入性治疗。亚组分析中,CHB组不良结局发生率高于CHC组(p < 0.05)。结论CVH合并AMI患者临床预后较差。CHB亚组的预后较CHC亚组差。