Key result
Among hospitalized patients with chronic coronary total occlusion, the occurrence of ventricular tachyarrhythmias was associated with significantly higher in-hospital mortality (10.2% vs 2.0%, aOR 4.45).
Why the study?
Trends and frequencies of ventricular tachyarrhythmia among patients with chronic coronary total occlusion were not established.
Does the occurrence of ventricular tachyarrhythmia worsen in-hospital outcomes and mortality in patients with chronic coronary total occlusion?
Observational (n=911,579)
Yes
Does the occurrence of ventricular tachyarrhythmia worsen in-hospital outcomes and mortality in patients with chronic coronary total occlusion?
Odds Ratio: 4.45 (95% CI 4.16–4.75)
Absolute Event Rate: 10.2% vs 2%
p-value: p=<0.001
Ventricular tachyarrhythmias occur in approximately 10% of hospitalizations for chronic coronary total occlusion and are associated with a more than four-fold increased odds of in-hospital mortality and higher resource utilization.
Ventricular tachyarrhythmias may warrant closer monitoring in hospitalized chronic coronary total occlusion; leaves open whether prevention improves survival.
Our study aims to establish trends and frequencies of ventricular tachyarrhythmia (VTA) among patients with chronic coronary total occlusion (CCTO). We identified CCTO hospitalizations with and without VTA using the National Inpatient Sample. A total of 911,579 CCTO-related hospitalizations were identified, with 92,450 (10.1%) encounters associated with VTA. The CCTO-VTA cohort showed higher all-cause mortality (adjusted odds ratio [aOR] = 4.45, P < 0.001), longer hospital stays (6.8 vs 4.6 days; P < 0.001), and higher hospital charges ($117,382 vs $75,419; P < 0.001) compared to the CCTO non-VTA group. Rates and odds of cardiogenic shock (aOR = 4.19), venous thromboembolism (aOR = 2.09), respiratory failure (aOR = 2.85), and requirement of mechanical ventilation (aOR = 4.23) were higher in the CCTO-VTA group (P < 0.001). Over time, there was an increase in VTA (9.2% in 2010 to 12.1% in 2014) and all-cause mortality (7.5% in 2010 to 12.4% in 2014; P < 0.001). Trends in VTA among patients with CCTO increased by 4.8% for undergoing percutaneous coronary intervention and by 2.5% for undergoing both percutaneous coronary intervention and coronary artery bypass grafting (P < 0.001). Occurrence of VTA among CCTO patients is associated with worse outcomes and higher resource utilization.
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Patel et al. (2021) conducted an observational in Chronic coronary total occlusion (n=911,579). Ventricular tachyarrhythmias vs. No ventricular tachyarrhythmias was evaluated on All-cause in-hospital mortality (aOR 4.45, 95% CI 4.16-4.75, p=<0.001). Among hospitalized patients with chronic coronary total occlusion, the occurrence of ventricular tachyarrhythmias was associated with significantly higher in-hospital mortality (10.2% vs 2.0%, aOR 4.45).
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