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Cardiovascular Outcomes in Patients With Mitochondrial Disease in the United States: A Propensity Score Analysis.

ABSTRACT: Mitochondrial disease comprises a wide range of genetic disorders caused by mitochondrial dysfunction. Its rarity, however, has limited the ability to assess its effects on clinical outcomes. To evaluate this relationship, we collected data from the 2016 National Inpatient Sample, which includes data from >7 million hospital stays. We identified 705 patients (mean age, 22 ± 20.7 yr; 54.2% female; 67.4% white) whose records included the ICD-10-CM code E88.4. We also identified a propensity-matched cohort of 705 patients without mitochondrial disease to examine the effect of mitochondrial disease on major adverse cardiovascular events, including all-cause in-hospital death, cardiac arrest, and acute congestive heart failure. Patients with mitochondrial disease were at significantly greater risk of major adverse cardiovascular events (odds ratio [OR]=2.42; 95% CI, 1.29-4.57; P=0.005), systolic heart failure (OR=2.37; 95% CI, 1.08-5.22; P=0.027), and all-cause in-hospital death (OR=14.22; 95% CI, 1.87-108.45; P<0.001). These findings suggest that mitochondrial disease significantly increases the risk of inpatient major adverse cardiovascular events.

SUBMITTER: Nguyen T

PROVIDER: S-EPMC8367288 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Cardiovascular Outcomes in Patients With Mitochondrial Disease in the United States: A Propensity Score Analysis.

Nguyen Tran T Alzahrani Talal T Krepp Joseph J Panjrath Gurusher G

Texas Heart Institute journal 20210701 3

Mitochondrial disease comprises a wide range of genetic disorders caused by mitochondrial dysfunction. Its rarity, however, has limited the ability to assess its effects on clinical outcomes. To evaluate this relationship, we collected data from the 2016 National Inpatient Sample, which includes data from >7 million hospital stays. We identified 705 patients (mean age, 22 ± 20.7 yr; 54.2% female; 67.4% white) whose records included the ICD-10-CM code E88.4. We also identified a propensity-matche ...[more]

PMID: 34383956

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Project description:BackgroundNicotine product use, including cigarette smoking and other nicotine products, is a known risk factor for various health complications. While previous studies have examined its impact on spinal procedures, its specific effects on cervical disc arthroplasty (CDA) remain unclear. This study aims to investigate the association between nicotine product use and inpatient outcomes in patients undergoing CDA.MethodsData from the 2005 to 2020 US Nationwide Inpatient Sample database of hospitalized adults ≥ 18 years old who underwent primary or revision CDA were extracted. Patients were divided into nicotine product users and non-users. Propensity score matching (PSM) was employed to balance the baseline characteristics between the groups. In-hospital mortality, unfavorable discharge, length of stay (LOS), and complications were compared between nicotine product users and non-users through logistic regression analyses.ResultsAfter 1:1 PSM, 5,562 patients were included in the analysis. After adjustment, nicotine product users had a significantly elevated risk of overall complications (adjusted odds ratio [aOR] = 1.37, 95% confidence interval [CI]: 1.13-1.66, p = 0.002) and infection (aOR = 1.74, 95% CI: 1.17-2.58, p = 0.006). No significant association was observed between nicotine product use and the risk of unfavorable discharge or prolonged LOS (both, p > 0.05). In stratified analyses, male, but not female nicotine product users, had a greater risk of infection (aOR = 2.12, 95% CI: 1.22-3.70, p = 0.008). Nicotine product use was significantly associated with higher infection risk among individuals without diabetes, obesity, and chronic pulmonary disease (p < 0.05).ConclusionsNicotine product use is associated with a higher risk of complications following CDA, particularly infections. The study highlights the importance of considering nicotine product use during preoperative assessments and postoperative care for patients undergoing CDA.

Project description:BackgroundCoronary heart disease due to arteriosclerosis is the leading cause of death in type 1 diabetic patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the effect of simultaneous pancreas kidney transplantation (SPKT) compared to kidney transplantation alone (KTA) on survival, cardiovascular function and metabolic outcomes.MethodsA cohort of 127 insulin-dependent diabetes mellitus (IDDM) patients with ESRD who underwent either SPKT (n = 100) or KTA (n = 27) between 1998 and 2019 at the University Hospital of Leipzig were retrospectively evaluated with regard to cardiovascular and metabolic function/outcomes as well as survival rates. An additional focus was placed on the echocardiographic assessment of systolic and diastolic cardiac function pretransplant and during follow-up. To avoid selection bias, a 2:1 propensity score matching analysis (PSM) was performed.ResultsAfter PSM, a total of 63 patients were identified; 42 patients underwent SPKT, and 21 patients received KTA. Compared with the KTA group, SPKT recipients received organs from younger donors (p < 0.05) and donor BMI was higher (p = 0.09). The risk factor-adjusted hazard ratio for mortality in SPKT recipients compared to KTA recipients was 0.63 (CI: 0.49-0.89; P < 0.05). The incidence of pretransplant cardiovascular events was higher in the KTA group (KTA: n = 10, 47% versus SPKT: n = 10, 23%; p = 0.06), but this difference was not significant. However, the occurrence of cardiovascular events in the SPKT group (n = 3, 7%) was significantly diminished after transplantation compared to that in the KTA recipients (n = 6, 28%; p = 0.02). The cardiovascular death rate was higher in KTA recipients (19%) than in SPK recipients with functioning grafts (3.3%) and comparable to that in patients with failed SPKT (16.7%) (p = 0.16). In line with pretransplant values, SPKT recipients showed significant improvements in Hb1ac values (p = 0.001), blood pressure control (p = < 0.005) and low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio (p = < 0.005) 5 years after transplantation. With regard to echocardiographic assessment, SPKT recipients showed significant improvements in left ventricular systolic parameters during follow-up.ConclusionsNormoglycaemia and improvement of lipid metabolism and blood pressure control achieved by successful SPKT are associated with beneficial effects on survival, cardiovascular outcomes and systolic left ventricular cardiac function. Future studies with larger samples are needed to make predictions regarding cardiovascular events and graft survival.

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Cardiovascular Outcomes in Patients With Mitochondrial Disease in the United States: A Propensity Score Analysis.

Publications

Cardiovascular Outcomes in Patients With Mitochondrial Disease in the United States: A Propensity Score Analysis.

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