Temporal trends in prevalence and outcomes of atrial fibrillation in patients undergoing percutaneous coronary intervention.
BACKGROUND
Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing percutaneous coronary intervention (PCI).


HYPOTHESIS
Large administrative data may provide further insight into temporal trends in the prevalence and burden of AF in patients who underwent PCI.


METHODS
Using the National Inpatient Sample database in the U.S., AF patients ≥18 years who underwent PCI between 2005 and 2014 and were identified by the International Classification of Diseases, ninth revision, Clinical Modification, were examined. In-hospital mortality, morbidity, resource use, and medical costs were evaluated in crude and propensity-matched analyses.


RESULTS
Among an estimated 6 272 232 hospitalizations, of patients undergoing PCI, AF prevalence was 9.9% and steadily increased from 8.6% to 12.0% between 2005 and 2014 (P < .001); there was also a greater proportion of comorbidities. There was a marked increase in AF prevalence among those aged ≥65 years and those undergoing elective PCIs. AF was independently associated with higher in-hospital mortality and higher rates of transient ischaemic attack/stroke, bleeding complications, and non-home discharge. Excessive in-hospital mortality, stroke rate, gastrointestinal bleeding, blood transfusion, length of stay, and costs among AF hospitalizations were consistently observed throughout the study period.


CONCLUSION
AF becomes more prevalent in patients undergoing PCI, possibly due to a higher comorbidity, particularly in elderly patients with non-acute indications. Less favorable trends in mortality, bleeding, and stroke among AF patients who underwent PCI were consistent over time. Continuous efforts are needed to improve outcomes and manage strategies for AF patients undergoing PCI.
['Morita|Yusuke|Y|https://orcid.org/0000-0002-6246-640X', 'Hamaguchi|Toka|T|', 'Yamaji|Yuhei|Y|', 'Hayashi|Hideyuki|H|', 'Nakane|Eisaku|E|', 'Haruna|Yoshisumi|Y|', 'Haruna|Tetsuya|T|', 'Hanyu|Michiya|M|', 'Inoko|Moriaki|M|']
D000368:Aged D000369:Aged, 80 and over D000925:Anticoagulants D001281:Atrial Fibrillation D015897:Comorbidity D003327:Coronary Disease D016208:Databases, Factual D005260:Female D017048:Health Care Costs D006295:Health Resources D017052:Hospital Mortality D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D062645:Percutaneous Coronary Intervention D015995:Prevalence D057216:Propensity Score D013997:Time Factors D016896:Treatment Outcome D014481:United States
atrial fibrillation percutaneous coronary intervention epidemiology