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Clinical Outcomes of Sickle Cell Disease Patients With Myocardial Infarction Undergoing Percutaneous Coronary
Oluwasegun M Akinti1, Jamal C Perry2, Temi Ediale1
1Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.
Insights
Sickle cell disease (SCD) patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) have higher rates of heart failure. However, other cardiovascular complications and mortality did not significantly differ from non-SCD patients.
Area of Science:
- Cardiology
- Hematology
- Public Health
Background:
- Sickle cell disease (SCD) patients face increased cardiovascular risks.
- Clinical outcomes for SCD patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) are not well-established.
- Understanding these outcomes is crucial for managing SCD-related cardiovascular complications.
Purpose of the Study:
- To analyze the clinical outcomes of SCD patients who experienced MI and underwent PCI.
- To identify potential complications in SCD patients post-PCI for MI.
- To compare outcomes between SCD and non-SCD patients undergoing the same interventions.
Main Methods:
- Retrospective analysis of the National Inpatient Sample (NIS) database (2016-2020).
- Inclusion of SCD patients who suffered MI and underwent PCI.
- Comparison with non-SCD patients using logistic, linear, and Poisson regression models.
Main Results:
- SCD patients (n=775) had higher rates of comorbidities like diabetes, obesity, and chronic kidney disease (CKD).
- Heart failure incidence was significantly higher in SCD patients (34.19%) compared to non-SCD patients (26.02%) (OR 1.5, p=0.02).
- Mortality and other cardiovascular complications (stroke, arrhythmias, shock) did not significantly differ between groups.
Conclusions:
- SCD patients undergoing PCI for MI exhibit distinct clinical outcomes, notably a higher incidence of heart failure.
- While mortality and major complications were similar, increased heart failure risk warrants attention in SCD management.
- Further research into SCD-specific cardiovascular risk stratification and treatment optimization is recommended.
Abstract:
Sickle cell disease (SCD) patients are predisposed to various cardiovascular complications due to the nature and progression of the disease; the clinical outcomes of SCD patients experiencing myocardial infarction (MI) and undergoing percutaneous coronary intervention (PCI) are not well known. This study aims to explore a comprehensive nationwide analysis of the clinical outcomes in SCD patients who have suffered an MI and subsequently undergone PCI. It also identifies potential complications and compares their outcomes with non-SCD counterparts with the same interventions. We conducted a retrospective analysis of SCD patients who have suffered an MI and subsequently undergone PCI using the National Inpatient Sample (NIS) database from 2016 to 2020. The primary outcome was mortality, while the secondary outcomes were the average length of stay, comorbid conditions, and cardiovascular outcomes. Logistic, linear, and Poisson regression model analysis applied for outcomes and adjusting co-founders. P-value <0.05 was considered significant. A total of 775 patients were analyzed for MI who had PCI with SCD, with a mean age of 58±1.06 years. SCD patients exhibited higher rates of comorbidities, including diabetes mellitus (45.81% vs. 37.84%), obesity (23.87% vs. 20.85%), and chronic kidney disease (CKD) (29.03% vs. 17.36%). Heart failure was more common among SCD patients with 34.19% vs. 26.02% in non-SCD patients (OR 1.5, CI 1.1-2.1, p-value=0.02). Other cardiovascular complications such as stroke, ventricular arrhythmias, atrial fibrillation, pulmonary edema, cardiogenic shock, cardiac arrest, and mortality did not significantly differ between SCD and non-SCD (P-values >0.05). The study observed that SCD patients experienced a significantly higher incidence of heart failure than non-SCD patients. This implies that SCD patients undergoing PCI for MI exhibit distinct clinical outcomes compared to their non-SCD counterparts.
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