CRT-101.10 Outcomes of Underlying Infiltrative Cardiomyopathy in Percutaneous Coronary Intervention
Hussain B, Basir MB, and Paul T. CRT-101.10 Outcomes of Underlying Infiltrative Cardiomyopathy in Percutaneous Coronary Intervention. JACC Cardiovasc Interv 2023; 16(4):S8.
JACC Cardiovasc Interv
Background: Evidence on the prognosis of infiltrative cardiomyopathy in patients undergoing percutaneous coronary intervention (PCI) has not been well established. Our objective was to assess the prevalence of infiltrative cardiomyopathy including amyloidosis, sarcoidosis and hemochromatosis in PCI patients and its effect on mortality.
Methods: National Inpatient Sample 2016-2019 was used to conduct a retrospective analysis by identifying a cohort of patients who underwent PCI with infiltrative cardiomyopathy using respective ICD-10 codes. Primary outcome was the effect of infiltrative cardiomyopathy on mortality in patients undergoing PCI. Secondary outcomes were the independent predictors of mortality. Multivariate logistic regression model was used for analysis.
Results: 1.93 million patients were hospitalized for undergoing PCI, out of which 6270 patients had infiltrative cardiomyopathy (prevalence 0.33%). Subgroup analysis showed that 710 patients had underlying amyloidosis (prevalence 0.04%), 4300 patients had sarcoidosis (prevalence 0.23%) and 1280 patients had hemochromatosis (prevalence 0.07%). Mean age of patients undergoing PCI with infiltrative cardiomyopathy was 61 years, 54% were females and 53.5% were white. Patients undergoing PCI were predominantly males (67%) but patient with infiltrative cardiomyopathy who underwent PCI were predominantly females (54%). Underlying amyloidosis was associated with two fold increased odds of mortality in patients undergoing PCI (OR 2.13, 95% CI 1.08-4.23, p=0.029). While sarcoidosis (OR 1.11, 95% CI 0.73-1.7, p=0.6) and hemochromatosis (OR 0.79, 95% CI 0.32-1.92, p=0.6) were not significantly associated with mortality in patients undergoing PCI. The independent predictors of mortality in patients undergoing PCI with infiltrative cardiomyopathy are arrhythmias (OR 2.59, OR 1.14-5.9, p=0.02), cardiac arrest (OR 10.3, CI 3.8-27.6, p=0.00), pulmonary embolism (OR 5.8, CI 1.06-32.4, p=0.04), kidney disease (OR 4.5, CI 1.99-10.3, p=0.00) and liver disease OR 3.5, CI 1.34-9.1, p=0.01).
Conclusion: Prevalence of infiltrative cardiomyopathy in patients undergoing PCI is 0.33%. Amyloidosis is associated with significantly increased odds of mortality in patients undergoing PCI while sarcoidosis and hemochromatosis are not significantly associated with mortality. Arrhythmias, cardiac arrest, pulmonary embolism, kidney and liver disease are independently associated with increased mortality in infiltrative cardiomyopathy patients undergoing PCI.