Title

Impact of Arrhythmias on Hospitalizations in Patients With Cardiac Amyloidosis

Authors

Samarthkumar Thakkar, Department of Internal Medicine, Rochester General Hospital, Rochester, New York.
Harsh P. Patel, Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, Illinois.
Medhat Chowdhury, Department of Internal Medicine, Rochester General Hospital, Rochester, New York.
Kirtenkumar Patel, Department of Cardiology, North Shore University Hospital, Manhasset, New York.
Ashish Kumar, Department of Critical Care Medicine, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Shilpkumar Arora, Department of Cardiology, Case Western University, Cleveland, Ohio.
Salman Zahid, Department of Internal Medicine, Rochester General Hospital, Rochester, New York.
Mishita Goel, Department of Internal Medicine, Wayne State University/APRH, Rochester, Michigan.
Kirolos Barssoum, Department of Internal Medicine, Rochester General Hospital, Rochester, New York.
Vardhmaan Jain, Department of Internal Medicine, Cleveland Clinic, Ohio.
Omar F. AbouEzzeddine, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Christopher V. DeSimone, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Bipul Baibhav, Sands Constellation Heart Institute, Rochester Regional Health, Rochester, New York.
Mohan Rao, Sands Constellation Heart Institute, Rochester Regional Health, Rochester, New York.
Abhishek Deshmukh, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: Deshmukh.Abhishek@mayo.edu.

Department

Internal Medicine

Document Type

Article

Publication Title

The American journal of cardiology

Abstract

Cardiac involvement in amyloidosis is associated with a poor prognosis. Data on the burden of arrhythmias in patients with cardiac amyloidosis (CA) during hospitalization are lacking. We identified the burden of arrhythmias using the National Inpatient Sample (NIS) database from January 2016 to December 2017. We compared patient characteristics, outcomes, and hospitalization costs between CA patients with and without documented arrhythmias. Out of 5,585 hospital admissions for CA, 2,020 (36.1%) had concurrent arrhythmias. Propensity-score matching for age, sex, income, and co-morbidities was performed with 1,405 CA patients with arrhythmias and 1,405 patients without. The primary outcome of all-cause mortality was significantly higher in CA patients with arrhythmia than without(13.9% vs 5.3%, p-value <0.001). Atrial fibrillation (AF) was the most common (72.2%) arrhythmia in CA patients with concurrent arrhythmia. The secondary outcomes of AF-related mortality (11.95% vs 9.16%, p-value = 0.02) and acute and acute on chronic as heart failure (HF) exacerbation (32.38% vs 24.91%, p-value <0.0001) were significantly higher in CA and concurrent arrhythmia compared with CA patients without. The total length of hospital stay (6[3 to 12] vs 5[3 to 10], p-value <0.001) and cost of hospitalization were ($ 15,086[7,813 to 30,373] vs $ 12,219[6,865 to 23,997], p-value = 0.001) were significantly greater among CA with arrhythmia compared with those without. These data suggest that the presence of arrhythmias in CA patients during hospital admission is associated with a poorer prognosis and may reflect patients with a higher risk of HF exacerbation and mortality.

First Page

125

Last Page

130

DOI

10.1016/j.amjcard.2020.12.024

Publication Date

12-23-2020

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