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J Interv Cardiol. 2004 Jun;17(3):151-8.

Predictors of hospital outcomes after percutaneous coronary intervention in the community.

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1
Division of Cardiology, Department of Internal Medicine, University of Washington, Seattle, WA 98103, USA.

Abstract

BACKGROUND:

It is not well established to what degree advances have been adopted into contemporary percutaneous coronary intervention (PCI) practice in the community and what effect they have on the short-term outcomes of in-hospital mortality and length of stay.

METHODS:

We analyzed a prospectively-collected, statewide registry that includes consecutive patients undergoing isolated PCI to determine predictors of in-hospital outcomes after the first PCI performed in the community. Multivariable logistic regression analysis was used to determine factors associated with in-hospital mortality after first PCI.

RESULTS:

Between January 1, 1999 and December 31, 2000 there were a total of 12,920 cases of first PCI performed, 4535 (35.1%) of which were for acute myocardial infarction (MI). Stents and glycoprotein (GP) IIb/IIIa inhibitors were used in 89.6% and 70.0%, respectively, of all cases. In-hospital mortality was 1.8%. Length of hospital stay was 1 (1, 3) days [median (interquartile range)] in the absence of acute MI, and 3 (2, 4) days after acute MI. After acute MI, peri-procedure GP IIb/IIIa inhibitor use [adjusted OR 0.41 (95% CI 0.26, 0.63)] and stenting [adjusted OR 0.61 (95% CI 0.37, 0.996)] were the only factors positively associated with freedom from hospital death.

CONCLUSIONS:

Intracoronary stenting and use of GP IIb/IIIa inhibitors have been well integrated into community practice. The observed in-hospital mortality rate is slightly higher than published in other series, but likely reflects the significant proportion of acute MI cases being treated aggressively with PCI as the primary therapy.

[Indexed for MEDLINE]

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