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Cardiac biomarker measurement after elective percutaneous coronary interventions in older patients: insights from the National Cardiovascular Data Registry.
- Source :
-
American heart journal [Am Heart J] 2013 Nov; Vol. 166 (5), pp. 927-34. Date of Electronic Publication: 2013 Oct 04. - Publication Year :
- 2013
-
Abstract
- Background: Guidelines recommend consideration of cardiac biomarker measurement after elective percutaneous coronary intervention (PCI), especially with complex cases or complicated procedures. However, the long-term prognostic implications of biomarker measurement after elective PCI have not been well characterized in older patients.<br />Methods: We examined 157,825 Medicare patients undergoing elective PCI in the United States from 2004 to 2008 at 711 hospitals in the CathPCI Registry. Clinical characteristics and 1-year mortality risk were studied, stratified by creatine kinase-muscle band measurement.<br />Results: Overall, 26% of patients on elective PCI had postprocedure biomarkers measured. These patients had more complex coronary anatomy and procedures but had similar rates of PCI success and inhospital mortality when compared with patients without biomarker measurement. The treating hospital was a significant factor associated with the likelihood of postprocedure biomarker surveillance. Hospitals that measured creatine kinase-muscle band in ≥ 90% of patients on elective PCI had lower associated 1-year mortality rates (adjusted hazard ratio 0.84, 95% CI 0.75-0.94) compared with hospitals that measured in < 10% of patients.<br />Conclusions: Among older patients undergoing elective PCI, postprocedure cardiac biomarker measurement occurred infrequently and was concentrated at certain hospitals. Hospitals that routinely measured post-PCI biomarkers were associated with lower long-term mortality compared with hospitals without routine measurement.<br /> (© 2013.)
- Subjects :
- Acute Coronary Syndrome mortality
Acute Coronary Syndrome surgery
Aged
Biomarkers blood
Female
Hospital Mortality
Hospitals
Humans
Length of Stay
Male
Medicare
Middle Aged
Myocardial Infarction mortality
Myocardial Infarction surgery
Prognosis
Registries
Survival Analysis
Survival Rate
Treatment Outcome
United States
Acute Coronary Syndrome blood
Creatine Kinase, MB Form blood
Elective Surgical Procedures mortality
Myocardial Infarction blood
Percutaneous Coronary Intervention mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6744
- Volume :
- 166
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 24176450
- Full Text :
- https://doi.org/10.1016/j.ahj.2013.09.007