Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample
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Authors
Desai, Rupak
Parekh, Tarang
Goyal, Hemant
Fong, Hee K.
Zalavadia, Dipen
Damarlapally, Nanush
Doshi, Rajkumar
Savani, Sejal
Kumar, Gautam
Sachdeva, Rajesh
Issue Date
2019
Type
Article
Language
Keywords
Acute coronary syndrome , Serum uric acid , acute myocardial-infarction , heart-disease , risk-factor , hyperuricemia , all-cause , cardiovascular mortality , Coronary artery bypass grafting , global registry , Gout , In-hospital outcomes , independent impact , Myocardial infarction , no-reflow phenomenon , Percutaneous coronary intervention , Revascularization , serum uric-acid , Unstable angina
Alternative Title
Abstract
Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS We used the national inpatient sample (2010-2014) to identify the ACS and gout-related hospitalizations, relevant comorbidities, revascularization and post-revascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACS-gout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17-1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization inhospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, post-operative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION Although gout was not independently associated with an increased risk of post-revascularization in-hospital mortality in ACS, it did increase post-revascularization complications.
Description
Citation
Desai, R., Parekh, T., Goyal, H., Fong, H. K., Zalavadia, D., Damarlapally, N., … Sachdeva, R. (2019). Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample. World Journal of Cardiology, 11(5), 137�"148. doi:10.4330/wjc.v11.i5.137
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License
Creative Commons Attribution-NonCommercial 4.0 International
Journal
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PubMed ID
ISSN
1949-8462