Waqas Ullah1, Nishant Thalambedu1, Salman Zahid2, Muhammad Zia Khan3, Tanveer Mir4, Sohaib Roomi1, David L Fischman5, Salim S Virani6,7, Mahboob Alam6. 1. Internal Medicine, Abington Jefferson Health, Abington, PA, USA. 2. Internal Medicine, Rochester General Hospital, Rochester, NY, USA. 3. Department of Medicine, University of West Virginia, Morgantown, WV, USA. 4. Department of Cardiovascular Medicine, Detroit Medical Center, Detroit, MI, USA. 5. Department of Cardiovascular Medicine, Thomas Jefferson University, Philadelphia, PA, USA. 6. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 7. Department of Cardiovascular Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Abstract
Cardiac allograft vasculopathy (CAV) is a major cause of heart transplant failure and mortality. The role of percutaneous coronary intervention (PCI) in these patients remains unknown. Methods: The National Inpatient Sample (NIS) (2015-2017) was queried to identify all cases of CAV. The merits of PCI were determined using a propensity-matched multivariate logistic regression model. Adjusted odds ratios (aOR) for in-hospital complications were calculated. Results: A total of 2,380 patients (PCI 185, no-PCI 21,95) with CAV were included in the analysis. There was no significant difference in the odds of major bleeding (OR 1.87, 95% CI 0.94-3.7, P = 0.11), post-procedure bleeding (P = 0.37), cardiogenic shock (OR 0.87, 95% CI 0.45-1.69, P = 0.80), acute kidney injury (uOR 0.92, 95% CI 0.68-1.24, P = 0.64), cardiopulmonary arrest (OR 0.84, 95% CI 0.34-2.11, P = 0.88), and in-hospital mortality (OR 1.59, 95% CI 0.91-2.79, P = 0.14) between patients undergoing PCI compared to those treated conservatively. A propensity-matched analysis closely followed the results of unadjusted crude analysis. Conclusion: PCI in CAV may be associated with increased in-hospital complications and higher resource utilization.
Cardiac allograft vasculopathy (CAV) is a major cause of heart transplant failure and mortality. The role of percutaneous coronary intervention (PCI) in these patients remains unknown. Methods: The National Inpatient Sample (NIS) (2015-2017) was queried to identify all cases of CAV. The merits of PCI were determined using a propensity-matched multivariate logistic regression model. Adjusted odds ratios (aOR) for in-hospital complications were calculated. Results: A total of 2,380 patients (PCI 185, no-PCI 21,95) with CAV were included in the analysis. There was no significant difference in the odds of major bleeding (OR 1.87, 95% CI 0.94-3.7, P = 0.11), post-procedure bleeding (P = 0.37), cardiogenic shock (OR 0.87, 95% CI 0.45-1.69, P = 0.80), acute kidney injury (uOR 0.92, 95% CI 0.68-1.24, P = 0.64), cardiopulmonary arrest (OR 0.84, 95% CI 0.34-2.11, P = 0.88), and in-hospital mortality (OR 1.59, 95% CI 0.91-2.79, P = 0.14) between patients undergoing PCI compared to those treated conservatively. A propensity-matched analysis closely followed the results of unadjusted crude analysis. Conclusion: PCI in CAV may be associated with increased in-hospital complications and higher resource utilization.