PMID- 25319740
OWN - NLM
STAT- MEDLINE
DCOM- 20160608
LR  - 20150905
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 49
IP  - 9
DP  - 2015 Oct
TI  - ST Elevation Myocardial Infarction Mortality Among Patients With Liver Cirrhosis: 
      A Nationwide Analysis Across a Decade.
PG  - 778-83
LID - 10.1097/MCG.0000000000000251 [doi]
AB  - BACKGROUND: Mortality from ST elevation myocardial infarction (STEMI) is 
      decreasing nationwide, but no report to date examined STEMI mortality among 
      patients with cirrhosis. GOALS: Determine mortality rates and investigate 
      possible disparities in cardiovascular interventions for patients with and 
      without cirrhosis admitted with STEMI across a decade using a national database. 
      STUDY: We included all urgent/emergent admissions with STEMI to acute care 
      hospitals across the United States in 1999 and 2009. Exclusion criteria were age 
      less than 18 years or prior liver transplantation. Confounders were accounted for 
      using multivariable regression analyses. RESULTS: A total of 325,857 and 182,491 
      patients with STEMI were included in 1999 and 2009, respectively, 741 and 541 of 
      whom had cirrhosis, respectively. In-hospital mortality rate was 31% and 11% for 
      patients with and without cirrhosis in 1999, and 17% and 9% in 2009. The adjusted 
      mortality odds ratio was 2.54 (1.52 to 4.24) in 1999 and 1.45 (0.73 to 2.86) in 
      2009. Stent placement rate was 11% and 26% for patients with and without 
      cirrhosis in 1999, and increased to 47% and 61% in 2009, respectively. 
      Thrombolytic medication injection rate was 3% and 10% for patients with and 
      without cirrhosis in 1999, and 0% and 2% in 2009, respectively. Coronary artery 
      bypass graft surgery rate was 3% and 9% for patients with and without cirrhosis 
      in 1999, and was 6% and 7% in 2009, respectively. CONCLUSIONS: STEMI mortality in 
      patients with cirrhosis is higher compared with patients without cirrhosis. 
      However, this mortality difference declined from 1999 to 2009, likely because of 
      higher coronary artery stent utilization for patients with cirrhosis.
FAU - Abougergi, Marwan S
AU  - Abougergi MS
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA.
FAU - Karagozian, Raffi
AU  - Karagozian R
FAU - Grace, Norman D
AU  - Grace ND
FAU - Saltzman, John R
AU  - Saltzman JR
FAU - Qamar, Amir A
AU  - Qamar AA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Coronary Artery Bypass/statistics & numerical data
MH  - Databases, Factual
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage
MH  - Hospital Mortality/*trends
MH  - Humans
MH  - Liver Cirrhosis/*mortality/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*mortality/physiopathology/therapy
MH  - Retrospective Studies
MH  - *Stents
MH  - United States
EDAT- 2014/10/17 06:00
MHDA- 2016/06/09 06:00
CRDT- 2014/10/17 06:00
PHST- 2014/10/17 06:00 [entrez]
PHST- 2014/10/17 06:00 [pubmed]
PHST- 2016/06/09 06:00 [medline]
AID - 10.1097/MCG.0000000000000251 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2015 Oct;49(9):778-83. doi: 10.1097/MCG.0000000000000251.