Impact of Arrhythmias on Hospitalizations in Patients With Cardiac Amyloidosis.
Adolescent
Adult
Aged
Amyloidosis
/ epidemiology
Arrhythmias, Cardiac
/ epidemiology
Atrial Fibrillation
/ epidemiology
Atrial Flutter
/ epidemiology
Cardiomyopathies
/ epidemiology
Case-Control Studies
Comorbidity
Disease Progression
Female
Heart Arrest
/ epidemiology
Heart Block
/ epidemiology
Heart Failure
/ epidemiology
Hospital Costs
/ statistics & numerical data
Hospital Mortality
Hospitalization
/ economics
Humans
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Propensity Score
Tachycardia, Supraventricular
/ epidemiology
Tachycardia, Ventricular
/ epidemiology
United States
/ epidemiology
Ventricular Fibrillation
/ epidemiology
Young Adult
Journal
The American journal of cardiology
ISSN: 1879-1913
Titre abrégé: Am J Cardiol
Pays: United States
ID NLM: 0207277
Informations de publication
Date de publication:
15 03 2021
15 03 2021
Historique:
received:
28
10
2020
revised:
05
12
2020
accepted:
08
12
2020
pubmed:
23
12
2020
medline:
7
4
2021
entrez:
22
12
2020
Statut:
ppublish
Résumé
Cardiac involvement in amyloidosis is associated with a poor prognosis. Data on the burden of arrhythmias in patients with cardiac amyloidosis (CA) during hospitalization are lacking. We identified the burden of arrhythmias using the National Inpatient Sample (NIS) database from January 2016 to December 2017. We compared patient characteristics, outcomes, and hospitalization costs between CA patients with and without documented arrhythmias. Out of 5,585 hospital admissions for CA, 2,020 (36.1%) had concurrent arrhythmias. Propensity-score matching for age, sex, income, and co-morbidities was performed with 1,405 CA patients with arrhythmias and 1,405 patients without. The primary outcome of all-cause mortality was significantly higher in CA patients with arrhythmia than without(13.9% vs 5.3%, p-value <0.001). Atrial fibrillation (AF) was the most common (72.2%) arrhythmia in CA patients with concurrent arrhythmia. The secondary outcomes of AF-related mortality (11.95% vs 9.16%, p-value = 0.02) and acute and acute on chronic as heart failure (HF) exacerbation (32.38% vs 24.91%, p-value <0.0001) were significantly higher in CA and concurrent arrhythmia compared with CA patients without. The total length of hospital stay (6[3 to 12] vs 5[3 to 10], p-value <0.001) and cost of hospitalization were ($ 15,086[7,813 to 30,373] vs $ 12,219[6,865 to 23,997], p-value = 0.001) were significantly greater among CA with arrhythmia compared with those without. These data suggest that the presence of arrhythmias in CA patients during hospital admission is associated with a poorer prognosis and may reflect patients with a higher risk of HF exacerbation and mortality.
Identifiants
pubmed: 33352208
pii: S0002-9149(20)31352-7
doi: 10.1016/j.amjcard.2020.12.024
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
125-130Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosures The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.