Patient Characteristics and Outcomes of Type 2 Myocardial Infarction During Heart Failure Hospitalizations in the United States

Author(s):  
Salik Nazir ◽  
Abdul Mannan Khan Minhas ◽  
Ishan S. Kamat ◽  
Robert W. Ariss ◽  
George V. Moukarbel ◽  
...  
Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Mohammed M Uddin ◽  
Tarec Micho Ulbeh ◽  
Tanveer Mir ◽  
Joseph Sebastian ◽  
Qasim Jehangir ◽  
...  

Background: The literature on the etiologies and complications of high-output heart failure (HOHF) is limited. Objective: To study the causes and complications related to HOHF in the United States (US). Methods: Data from the national readmissions database (NRD) sample that constitutes 49.1% of the stratified sample of all hospitals in the United States, representing more than 95% of the national population were analyzed for hospitalizations with primary diagnosis of HOHF for the years 2017-2018. Etiology associated with HOHF were extracted using ICD-10 codes. Results: A total of 2,107 index hospitalizations (mean age 62.2 ± 19.1) with primary diagnosis of HOHF were recorded in the NRD for the years 2017-2018. The most common causes of HOHF include sepsis 204 (9.7%), leukemia 53 (2.5%), arteriovenous fistula 13 (0.6%), liver cirrhosis 155 (7.4%), Hyperthyroidism 133 (6.3%), thalassemia 23 (1.14%), sickle cell disease 71 (3.35%), morbid obesity 188 (8.95%), COPD 406 (19.3%), myeloproliferative disorders 166 (7.87%). Among the HOHF group, major complications include acute ischemic stroke (42 or 2%), acute kidney injury (593 or 28.1%), hypertensive emergency (74 or 3.5%), atrial fibrillation (409 or 19.4%), ventricular tachycardia/fibrillation (77 or 3.7%), and conduction block (81 or 3.8%) and ST-Elevation myocardial infarction (11 or 0.5%). A total of 83 (3.9%) patients had died during the inpatient hospitalization. Out of the remaining 2,024 patients, a significant portion (62 or 3.1%) required readmission within 30 days. Conclusion: HOHF is an under-reported cardiovascular complication associated with non-cardiovascular disorders. HOHF is associated with significant 30-day readmissions and mortality rates. Proper management of the underlying etiology can prevent the development of HOHF and associated complications. Keywords: cirrhosis; hemodynamics; obesity, leukemia, myeloproliferative disorders, ST-Elevation myocardial infarction (STEMI).


2020 ◽  
Vol 22 (4) ◽  
pp. 705-710
Author(s):  
Ghadeer K. Dawwas ◽  
Charles E. Leonard ◽  
Mahek Garg ◽  
Scott M. Vouri ◽  
Steven M. Smith ◽  
...  

Author(s):  
Luke C. Cunningham ◽  
Gregg C. Fonarow ◽  
Clyde W. Yancy ◽  
Shubin Sheng ◽  
Roland A. Matsouaka ◽  
...  

Background Regional patient characteristics, care quality, and outcomes may differ based on a variety of factors among patients hospitalized for heart failure (HF). Regional disparities in outcomes of cardiovascular disease have been suggested across various regions in the United States. This study examined whether there are significant differences by region in quality of care and short‐term outcomes of hospitalized patients with HF across the United States. Methods and Results We examined regional demographics, quality measures, and short‐term outcomes across 4 US Census Bureau regions in patients hospitalized with HF and enrolled in the GWTG‐HF (Get With The Guidelines–Heart Failure) registry from 2010 to 2016. Differences in length of stay and mortality by region were examined with multivariable logistic regression. The study included 423 333 patients hospitalized for HF in 488 hospitals. Patients in the Northeast were significantly older. Completion of achievement measures, with few exceptions, were met with similar frequency across regions. Multivariable analysis demonstrated significantly lower in‐hospital mortality in the Midwest compared with the Northeast (hazard ratio, 0.64; 95% CI, 0.51–0.8; P <0.00001). The length of stay varied significantly by region with a significantly higher risk‐adjusted length of stay in the Northeast compared with other regions. Conclusions Although we did not find any substantial differences by region in quality of care in patients hospitalized for HF, risk‐adjusted inpatient mortality was found to be lower in the Midwest compared with the Northeast, and may be secondary to unmeasured differences in patient characteristics, and to longer length of stay in the Northeast.


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