Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

doi:10.1177/0003319715593853

. 2016 Apr;67(4):326-35.

doi: 10.1177/0003319715593853. Epub 2015 Jul 5.

Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

Shilpkumar Arora¹, Sidakpal S Panaich², Nileshkumar J Patel³, Nilay Patel⁴, Shantanu Solanki⁵, Abhishek Deshmukh⁶, Vikas Singh⁷, Sopan Lahewala⁸, Chirag Savani⁹, Badal Thakkar¹⁰, Abhishek Dave¹¹, Achint Patel⁵, Parth Bhatt¹⁰, Rajesh Sonani¹², Aashay Patel¹³, Michael Cleman¹⁴, John K Forrest¹⁴, Theodore Schreiber², Apurva O Badheka¹⁵, Cindy Grines²

Affiliations

¹ Internal Medicine Department, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, USA.
² Cardiovascular Department, Detroit Medical Center, Detroit, MI, USA.
³ Internal Medicine Department, Staten Island University Hospital, Staten Island, NY, USA.
⁴ Internal Medicine Department, Saint Peter's University Hospital, New Brunswick, NJ, USA.
⁵ Internal Medicine Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶ Cardiology Department, Mayo Clinic, Rochester, MN, USA.
⁷ Cardiology Department, University of Miami Miller School of Medicine, Miami, FL, USA.
⁸ Internal Medicine Department, Mount Sinai Hospital Center, New York, NY, USA.
⁹ Internal Medicine Department, New York Medical College, Valhalla, NY, USA.
¹⁰ Internal Medicine Department, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA.
¹¹ Internal Medicine Department, Texas A&M University, College Station, TX, USA.
¹² Internal Medicine Department, Emory University School of Medicine, Atlanta, GA, USA.
¹³ Internal Medicine Department, Lankenau Institute for Medical Research, Wynnewood, PA, USA.
¹⁴ Cardiology Department, Yale School of Medicine, New Haven, CT, USA.
¹⁵ Cardiology Department, Yale School of Medicine, New Haven, CT, USA apurva.badheka@yale.edu.

PMID: 26145455
DOI: 10.1177/0003319715593853

Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

Shilpkumar Arora et al. Angiology. 2016 Apr.

. 2016 Apr;67(4):326-35.

doi: 10.1177/0003319715593853. Epub 2015 Jul 5.

Authors

Affiliations

¹ Internal Medicine Department, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, USA.
² Cardiovascular Department, Detroit Medical Center, Detroit, MI, USA.
³ Internal Medicine Department, Staten Island University Hospital, Staten Island, NY, USA.
⁴ Internal Medicine Department, Saint Peter's University Hospital, New Brunswick, NJ, USA.
⁵ Internal Medicine Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶ Cardiology Department, Mayo Clinic, Rochester, MN, USA.
⁷ Cardiology Department, University of Miami Miller School of Medicine, Miami, FL, USA.
⁸ Internal Medicine Department, Mount Sinai Hospital Center, New York, NY, USA.
⁹ Internal Medicine Department, New York Medical College, Valhalla, NY, USA.
¹⁰ Internal Medicine Department, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA.
¹¹ Internal Medicine Department, Texas A&M University, College Station, TX, USA.
¹² Internal Medicine Department, Emory University School of Medicine, Atlanta, GA, USA.
¹³ Internal Medicine Department, Lankenau Institute for Medical Research, Wynnewood, PA, USA.
¹⁴ Cardiology Department, Yale School of Medicine, New Haven, CT, USA.
¹⁵ Cardiology Department, Yale School of Medicine, New Haven, CT, USA apurva.badheka@yale.edu.

PMID: 26145455
DOI: 10.1177/0003319715593853

Abstract

Background: Multivessel coronary artery disease carries significant mortality risk. Comprehensive data on inhospital outcomes following multivessel percutaneous coronary intervention (MVPCI) are sparse.

Methods: We queried the Healthcare Cost and Utilization Project's nationwide inpatient sample (NIS) between 2006 and 2011 using different International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The primary outcome was inhospital all-cause mortality, and the secondary outcome was a composite of inhospital mortality and periprocedural complications.

Results: The overall mortality was low at 0.73% following MVPCI. Multivariate analysis revealed that (odds ratio, 95% confidence interval, P value) age (1.63, 1.48-1.79; <.001), female sex (1.19, 1.00-1.42; P = .05), acute myocardial infarction (AMI; 2.97, 2.35-3.74; <.001), shock (17.24, 13.61-21.85; <.001), a higher burden of comorbidities (2.09, 1.32-3.29; .002), and emergent/urgent procedure status (1.67, 1.30-2.16; <.001) are important predictors of primary and secondary outcomes. MVPCI was associated with higher mortality, length of stay (LOS), and cost of care as compared to single vessel single stent PCI.

Conclusion: MVPCI is associated with higher inhospital mortality, LOS, and hospitalization costs compared to single vessel, single stent PCI. Higher volume hospitals had lower overall postprocedural mortality rate along with shorter LOS and lower hospitalization costs following MVPCI.

Keywords: hospital volume; mortality; multivessel percutaneous coronary interventions.

PubMed Disclaimer

Comment in

Multiple Coronary Artery Interventions.
Whayne TF Jr. Whayne TF Jr. Angiology. 2016 May;67(5):427-30. doi: 10.1177/0003319715595746. Epub 2015 Jul 17. Angiology. 2016. PMID: 26187641 No abstract available.

Cited by

Multivessel vs. culprit vessel-only percutaneous coronary intervention in ST-segment elevation myocardial infarction with and without cardiogenic shock.
Wu J, Wang Y, Li C, Ji H, Zhao W, Tong Q, Zhang M. Wu J, et al. Front Cardiovasc Med. 2022 Nov 24;9:992456. doi: 10.3389/fcvm.2022.992456. eCollection 2022. Front Cardiovasc Med. 2022. PMID: 36505378 Free PMC article.
The relationship between procedural volume and patient outcomes for percutaneous coronary interventions: a systematic review and meta-analysis.
Walsh KA, Plunkett T, O'Brien KK, Teljeur C, Smith SM, Harrington P, Ryan M. Walsh KA, et al. HRB Open Res. 2021 Jan 28;4:10. doi: 10.12688/hrbopenres.13203.1. eCollection 2021. HRB Open Res. 2021. PMID: 33842830 Free PMC article.
Effect of Aggressive Lipid-Lowering Therapy in Single-Vessel vs. Multivessel Coronary Artery Disease Patients With Acute Coronary Syndrome　- Heart Institute of Japan-Proper Level of Lipid Lowering With Pitavastatin and Ezetimibe in Acute Coronary Syndrome (HIJ-PROPER) Substudy.
Ogiso M, Yamaguchi J, Kawada-Watanabe E, Koyanagi R, Sekiguchi H, Sakamoto T, Iguchi N, Tanaka H, Okada H, Ota Y, Jujo K, Fujii S, Ogawa H, Hagiwara N. Ogiso M, et al. Circ Rep. 2020 Jan 28;2(2):128-134. doi: 10.1253/circrep.CR-19-0118. Circ Rep. 2020. PMID: 33693218 Free PMC article.
Racial and sex disparities in resource utilization and outcomes of multi-vessel percutaneous coronary interventions (a 5-year nationwide evaluation in the United States).
Desai R, Singh S, Fong HK, Goyal H, Gupta S, Zalavadia D, Doshi R, Savani S, Pancholy S, Sachdeva R, Kumar G. Desai R, et al. Cardiovasc Diagn Ther. 2019 Feb;9(1):18-29. doi: 10.21037/cdt.2018.09.02. Cardiovasc Diagn Ther. 2019. PMID: 30881873 Free PMC article.

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Atypon
- Ovid Technologies, Inc.
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

Affiliations

Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

Authors

Affiliations

Abstract

Comment in

Similar articles

Cited by

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous