Elkaryoni Ahmed, Hussain Fizza, Chahine Nicole, Khan Rizwan, Malhotra Akshay, Mentias Amgad, Alkhouli Mohamad A, Sharaf Barry L, Gordon Paul, Lopez John J, Aronow Herbert D, Abbott Jinnette Dawn, Saad Marwan
Division of Cardiovascular Disease, Loyola University Medical Center, Loyola Stritch School of Medicine, Maywood, IL.
Division of Cardiovascular Disease, Loyola University Medical Center, Loyola Stritch School of Medicine, Maywood, IL.
Curr Probl Cardiol. 2022 Dec;47(12):101367. doi: 10.1016/j.cpcardiol.2022.101367. Epub 2022 Aug 23.
Percutaneous balloon mitral valvuloplasty (PBMV) is primarily performed for rheumatic mitral stenosis (MS). Therefore, limited data exist on PBMV in countries with a low incidence of rheumatic disease. Using the Nationwide Readmission Database, we examined trends in in-hospital mortality and 30-day readmission among patients who received PBMV for rheumatic and non-rheumatic MS. We also examined the change in 90-day hospitalization rate before vs after PBMV. Between 2016 and 2019, there were 1109 hospitalizations in which patients received PBMV for rheumatic (n = 955, 86.1%) vs non-rheumatic MS (n = 154, 13.9%). The all-cause in-hospital mortality for rheumatic and non-rheumatic MS did not change over time (0.9% → 2.0%, P = 0.94, and 5.9% → 9.5%, P = 0.09 respectively). Similarly, the 30-day readmission for patients with rheumatic and non-rheumatic MS did not change over time (12.4% → 9.9%, P = 0.26, and 4.4% → 10.5%, P = 0.30, respectively). The 90-day all-cause hospitalization rate remained the same before vs after PBMV for rheumatic and non-rheumatic MS (25.5% → 21.8%; P = 0.14, and 24.0% → 33.7%; P = 0.19, respectively). Although no statistically significant change was noted over time for trends in in-hospital mortality, 30-day readmission, or even in the change in 90-day all-cause hospitalizations before and after PBMV for both types of MS, among those with non-rheumatic MS, there was a signal of an increase in the in-hospital mortality, and 30-day readmission, even more, there was 29% relative increase in 90-day hospitalizations after PBMV. Future studies are needed to examine the role of PBMV in patients with non-rheumatic MS.
经皮气球二尖瓣成形术（PBMV）主要用于治疗风湿性二尖瓣狭窄（MS）。因此，在风湿性疾病发病率较低的国家，关于PBMV的数据有限。利用全国再入院数据库，我们研究了接受PBMV治疗风湿性和非风湿性MS患者的院内死亡率和30天再入院率趋势。我们还研究了PBMV前后90天住院率的变化。2016年至2019年期间，共有1109例住院患者接受了PBMV治疗，其中风湿性MS患者955例（86.1%），非风湿性MS患者154例（13.9%）。风湿性和非风湿性MS的全因院内死亡率随时间没有变化（分别从0.9%升至2.0%，P = 0.94；从5.9%升至9.5%，P = 0.09）。同样，风湿性和非风湿性MS患者的30天再入院率随时间也没有变化（分别从12.4%降至9.9%，P = 0.26；从4.4%升至10.5%，P = 0.30）。风湿性和非风湿性MS患者PBMV前后的90天全因住院率保持不变（分别从25.5%降至21.8%；P = 0.14；从24.0%升至33.7%；P = 0.19）。虽然两种类型的MS患者在院内死亡率、30天再入院率以及PBMV前后90天全因住院率变化趋势上，随时间均未观察到统计学上的显著变化，但在非风湿性MS患者中，存在院内死亡率和30天再入院率上升的迹象，甚至PBMV后90天住院率相对增加了29%。未来需要进一步研究以探讨PBMV在非风湿性MS患者中的作用。
