Subahi Ahmed, Abdullah Abdullah, Yassin Ahmed S, Abubakar Hossam, Abugroun Ashraf, Eigbire George, Salama Amr, Wahab Abdul, Abulawi Ayman, Kanaan Eyas, Javed Aamer, Elder Mahir, Kaki Amir, Alweis Richard, Mohamad Tamam
Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, USA.
Department of Internal Medicine, Rochester Regional Health System (Unity Hospital), Rochester, NY, USA.
Cardiovasc Revasc Med. 2019 Aug;20(8):659-662. doi: 10.1016/j.carrev.2018.09.008. Epub 2018 Sep 13.
Congestive heart failure (CHF) is seen in up to 13-25% of patients with NSTEMI. Recent data describing the impact of congestive heart failure (CHF) on in-hospital outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) in the United States is limited. We sought to examine the in-hospital outcomes, and management of CHF in patients admitted to the hospital with NSTEMI.
National Inpatient Sample (NIS) database (2010-2014) was analyzed to identify patients with NSTEMI using ICD-9-CM codes. The primary outcome was in-hospital mortality. Propensity score-matching analysis compared mortality in CHF patients to matched controls without CHF.
Of 247,624 patients with NSTEMI, 84,115 (34%) had CHF. Patients with CHF were less likely to receive percutaneous coronary intervention (PCI) [20.48% vs. 40.9%, P < 0.001] or coronary artery bypass grafting (CABG) [8.2% vs 9.6%, P < 0.001] during hospitalization. Also, they had longer lengths of stay and higher risk for in-hospital adverse outcomes. CHF was the strongest predictor of in-hospital death. The increased mortality risk was persistent after propensity matching (RR 1.27; 95% CI 1.22 to 1.33).
CHF among patients with NSTEMI is associated with increased risk for in-hospital mortality and adverse outcomes.
充血性心力衰竭（CHF）在非ST段抬高型心肌梗死（NSTEMI）患者中的发生率高达13%-25%。近期关于美国充血性心力衰竭（CHF）对非ST段抬高型心肌梗死（NSTEMI）患者住院结局影响的数据有限。我们旨在研究因NSTEMI入院患者的住院结局及CHF的管理情况。
分析国家住院患者样本（NIS）数据库（2010-2014年），使用国际疾病分类第九版临床修订本（ICD-9-CM）编码识别NSTEMI患者。主要结局为住院死亡率。倾向评分匹配分析比较了CHF患者与匹配的无CHF对照组的死亡率。
在247,624例NSTEMI患者中，84,115例（34%）患有CHF。CHF患者在住院期间接受经皮冠状动脉介入治疗（PCI）[20.48%对40.9%，P<0.001]或冠状动脉旁路移植术（CABG）[8.2%对9.6%，P<0.001]的可能性较小。此外，他们的住院时间更长，住院不良结局风险更高。CHF是住院死亡的最强预测因素。倾向匹配后，死亡风险增加仍然存在（相对危险度1.27；95%置信区间1.22至1.33）。
NSTEMI患者中的CHF与住院死亡率和不良结局风险增加相关。
