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Comparison of Outcomes of Patients With Versus Without Chronic Liver Disease Undergoing Percutaneous Coronary

Sedralmontaha Istanbuly1, Andrija Matetic2, Mohamed O Mohamed3

  • 1Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic; Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom.

The American Journal of Cardiology
|August 5, 2021
PubMed

Insights

Patients with chronic liver disease (CLD) undergoing percutaneous coronary intervention (PCI) face higher risks of adverse outcomes, including mortality and major bleeding. Severe CLD and alcohol-related liver disease significantly increase these risks.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Limited data exist on outcomes for chronic liver disease (CLD) patients undergoing percutaneous coronary intervention (PCI).
  • Understanding these outcomes is crucial for optimizing patient care and risk stratification.

Purpose of the Study:

  • To investigate the in-hospital adverse outcomes of patients with CLD undergoing PCI.
  • To compare outcomes based on CLD severity, etiology, and PCI indication.

Main Methods:

  • Analysis of Nationwide Inpatient Sample data (2004-2015) for PCI hospitalizations.
  • Stratification of patients by CLD presence, cause, severity, and PCI indication.
  • Multivariable logistic regression to determine adjusted odds ratios (aOR) for adverse outcomes.

Main Results:

  • 0.7% of 7,296,679 PCI admissions had CLD; 67.8% of these had severe CLD.
  • CLD patients had higher odds of major adverse cardiovascular and cerebrovascular events (MACCE) (aOR 1.25), mortality (aOR 1.43), and major bleeding (aOR 2.22).
  • Severe CLD, alcohol-related liver disease, and other CLD etiologies were associated with significantly worse outcomes, while chronic viral hepatitis only increased bleeding risk.

Conclusions:

  • CLD patients undergoing PCI have significantly worse in-hospital outcomes.
  • Severe CLD and specific etiologies like alcohol-related liver disease portend the highest risk for adverse events.
  • Risk stratification and tailored management strategies are essential for CLD patients undergoing PCI.

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