Multivessel percutaneous coronary interventions in the United States

Shilpkumar Arora, Sidakpal S. Panaich, Nileshkumar J. Patel, Nilay Patel, Shantanu Solanki, Abhishek Deshmukh, Vikas Singh, Sopan Lahewala, Chirag Savani, Badal Thakkar, Abhishek Dave, Achint Patel, Parth Bhatt, Rajesh Sonani, Aashay Patel, Michael Cleman, John K. Forrest, Theodore Schreiber, Apurva O. Badheka, Cindy Grines

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)326-335
Number of pages10
JournalAngiology
Volume67
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Keywords

  • hospital volume
  • mortality
  • multivessel percutaneous coronary interventions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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