Will Maximilian, Schwarz Konstantin, Holroyd Eric, Borovac Josip A, Qureshi Adnan I, Lip Gregory Y H, Mascherbauer Julia, Leibundgut Gregor, Weiss Thomas W, Kwok Chun Shing
Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.
Division of Internal Medicine 3, University Hospital St. Pölten, Dunant-Platz 1, 3100 St. Pölten, Austria.
J Cardiovasc Dev Dis. 2025 Mar 14;12(3):100. doi: 10.3390/jcdd12030100.
The impact of atrial fibrillation (AF) on patients with chronic total occlusions (CTOs) at the national level remains unclear. In this study, we conducted a retrospective analysis of data from the National Inpatient Sample to assess the characteristics and in-hospital outcomes of patients with CTO based on the presence or absence of AF. Multiple logistic and linear regressions examined factors associated with AF and evaluated its impact on length of stay (LoS), cost, and mortality. The analysis included 480,180 patients diagnosed with CTO, with AF present in 28.0% of cases. Patients with CTOs and AF were older (median age 73 vs. 66 years, < 0.001) and exhibited lower female representation (25.0% vs. 27.9%, < 0.001). Factors most strongly associated with AF included previous heart failure (OR 1.98, 95% CI 1.92-2.05, < 0.001), liver disease (OR 1.37, 95% CI 1.27-1.48, < 0.001), and obesity (OR 1.25, 95% CI 1.20-1.30, < 0.001). AF correlated with increased in-hospital mortality (OR 1.29, 95% CI 1.18-1.40, < 0.001), ischemic stroke (OR 1.27, 95% CI 1.13-1.42, < 0.001), and major bleeding (OR 1.38, 95% CI 1.30-1.46). Moreover, AF was associated with a longer LoS (coef 1.58, 95% CI 1.50 to 1.67, < 0.001) and higher in-hospital costs (coef 6.22, 95% CI 5.81 to 6.63, < 0.001). Patients with CTOs and AF were older and had more underlying health problems compared to patients without AF. The patients with AF have worse outcomes in terms of mortality, ischemic stroke, major bleeding, length of stay, and costs.
在国家层面，心房颤动（AF）对慢性完全闭塞（CTO）患者的影响仍不明确。在本研究中，我们对国家住院患者样本数据进行了回顾性分析，以评估基于有无AF的CTO患者的特征和住院结局。多元逻辑回归和线性回归分析了与AF相关的因素，并评估了其对住院时间（LoS）、费用和死亡率的影响。该分析纳入了480,180例被诊断为CTO的患者，其中28.0%的病例存在AF。患有CTO且伴有AF的患者年龄更大（中位年龄73岁对66岁，<0.001），女性比例更低（25.0%对27.9%，<0.001）。与AF关联最密切的因素包括既往心力衰竭（OR 1.98，95%CI 1.92 - 2.05，<0.001）、肝病（OR 1.37，95%CI 1.27 - 1.48，<0.001）和肥胖（OR 1.25，95%CI 1.20 - 1.30，<0.001）。AF与住院死亡率增加（OR 1.29，95%CI 1.18 - 1.40，<0.001）、缺血性卒中（OR 1.27，95%CI 1.13 - 1.42，<0.001）及大出血（OR 1.38，95%CI 1.30 - 1.46）相关。此外，AF与更长的住院时间（系数1.58，95%CI 1.50至1.67，<0.001）和更高的住院费用（系数6.22，95%CI 5.81至6.63，<0.001）相关。与无AF的患者相比，患有CTO且伴有AF的患者年龄更大，潜在健康问题更多。伴有AF的患者在死亡率、缺血性卒中、大出血、住院时间和费用方面结局更差。
