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Outcomes of percutaneous coronary intervention (PCI) among patients with connective tissue disease: Propensity match

Samson Alliu1, Justin Ugwu2, Omotooke Babalola3

  • 1Heart and Vascular Institute, Maimonides Medical Center, Brooklyn, NY, USA.

International Journal of Cardiology
|January 27, 2020
PubMed

Insights

Patients with connective tissue disease (CTD) undergoing percutaneous coronary intervention (PCI) face higher risks of acute kidney injury and access site complications. These patients also experienced a longer hospital stay compared to those without CTD.

Area of Science:

  • Cardiology
  • Rheumatology
  • Nephrology

Background:

  • Inflammation is central to coronary artery disease (CAD) and connective tissue diseases (CTD).
  • Increased CAD prevalence is noted in CTD patients, but PCI outcomes in this population are understudied.

Purpose of the Study:

  • To compare the outcomes of percutaneous coronary intervention (PCI) in patients with and without connective tissue disease (CTD).

Main Methods:

  • Utilized the National Inpatient Database (2007-2015) to identify patients undergoing PCI.
  • Employed propensity score matching (1:3) to compare outcomes between CTD and non-CTD groups.
  • Assessed outcomes including acute kidney injury (AKI), access site complications (ASC), ventricular fibrillation (VF), cardiogenic shock (CS), stroke, in-hospital mortality, and length of stay (LOS).

Main Results:

  • Identified 17,422 CTD patients matched with 52,266 non-CTD patients.
  • CTD patients showed significantly higher rates of AKI (8.3% vs. 6.6%), ASC (3.2% vs. 2.7%), and longer hospital stays (4.2 vs. 3.8 days).
  • No significant differences were observed in VF, CS, stroke, or in-hospital mortality rates between groups. Notably, VF rates were lower in Systemic Lupus Erythematosus (SLE) subgroup.

Conclusions:

  • Connective tissue disease patients undergoing PCI experience increased rates of AKI and ASC.
  • Prolonged hospital stay is also a significant outcome for CTD patients post-PCI.
  • While overall mortality and major adverse events were similar, specific complications and subgroup variations warrant further investigation.
Abstract

Keywords:
Access site complication (ASC)Acute kidney injury (AKI)Connective tissue disease (CTD)Percutaneous coronary intervention (PCI)

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