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Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample

Introduction Coronary artery aneurysms (CAA) are not commonly seen in the general population, with an incidence of approximately 0.37% to 2.53%. Patients are typically asymptomatic but symptomatic presentation varies from dyspnea and angina to myocardial infarction or even sudden cardiac death. Meth...

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Autores principales: Tandon, Varun, Tandon, Aysha A, Kumar, Manish, Mosebach, Christian M, Balakumaran, Kathir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687420/
https://www.ncbi.nlm.nih.gov/pubmed/31417821
http://dx.doi.org/10.7759/cureus.4876
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author Tandon, Varun
Tandon, Aysha A
Kumar, Manish
Mosebach, Christian M
Balakumaran, Kathir
author_facet Tandon, Varun
Tandon, Aysha A
Kumar, Manish
Mosebach, Christian M
Balakumaran, Kathir
author_sort Tandon, Varun
collection PubMed
description Introduction Coronary artery aneurysms (CAA) are not commonly seen in the general population, with an incidence of approximately 0.37% to 2.53%. Patients are typically asymptomatic but symptomatic presentation varies from dyspnea and angina to myocardial infarction or even sudden cardiac death. Methods We conducted a retrospective analysis using the National Inpatient Sample Healthcare Cost and Utilization Project (NIS-HCUP) database to query individuals with the diagnosis of CAA with the International Classification of Disease (ICD) code 414.11 in all discharge diagnoses for the years 2006-2014. History of Kawasaki disease was determined by ICD code 446.1. Results From 2006 to 2014, there were 23,033 patients identified with CAA, correlating to approximately one case per 10,000 patients or an incidence of close to 0.01%. Of this, 1,405 or approximately 6.1% of these patients had Kawasaki disease. The mortality rate of CAA was 1.79%. In terms of demographics, Caucasians were the most likely to develop CAA, with 73.8% of cases. The mean age was 61.2 years, with a mean length of stay of 5.1 days. The average cost of admission was $70892. The presence of perivascular disease (15.5% vs 4.5% p<0.05), hypertension (66.1% vs 39.1% p<0.05), chronic lung disease (20.2% vs 15.1% p<0.05), diabetes (21.7% vs 15% p<0.05), renal failure (11% vs 8.8% p<0.05), coagulopathy (6.2% vs 3.4% p<0.05), and obesity (13.1% vs 8.2% p<0.05) were all risk factors for CAA as compared to those without. It was noted that weight loss (3.28% vs 1.91% p<0.05), electrolyte abnormalities (18.2% vs 15.5% p<0.05), and blood loss (2.1% vs 0.9% p<0.05) were protective of CAA. Conclusion CAA risk factors appear to be similar to those of coronary artery disease risk factors, with hypertension, diabetes, perivascular disease, and renal failure. Additionally, obesity was noted to be a risk factor but weight loss appeared to be protective. Interestingly, Kawasaki disease was seen at almost similar rates as these cardiac risk factors. The incidence of CAA we found, of almost 0.01%, is much less than in the quoted literature, however, previous studies did not have as many cases as our study.
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spelling pubmed-66874202019-08-15 Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample Tandon, Varun Tandon, Aysha A Kumar, Manish Mosebach, Christian M Balakumaran, Kathir Cureus Cardiology Introduction Coronary artery aneurysms (CAA) are not commonly seen in the general population, with an incidence of approximately 0.37% to 2.53%. Patients are typically asymptomatic but symptomatic presentation varies from dyspnea and angina to myocardial infarction or even sudden cardiac death. Methods We conducted a retrospective analysis using the National Inpatient Sample Healthcare Cost and Utilization Project (NIS-HCUP) database to query individuals with the diagnosis of CAA with the International Classification of Disease (ICD) code 414.11 in all discharge diagnoses for the years 2006-2014. History of Kawasaki disease was determined by ICD code 446.1. Results From 2006 to 2014, there were 23,033 patients identified with CAA, correlating to approximately one case per 10,000 patients or an incidence of close to 0.01%. Of this, 1,405 or approximately 6.1% of these patients had Kawasaki disease. The mortality rate of CAA was 1.79%. In terms of demographics, Caucasians were the most likely to develop CAA, with 73.8% of cases. The mean age was 61.2 years, with a mean length of stay of 5.1 days. The average cost of admission was $70892. The presence of perivascular disease (15.5% vs 4.5% p<0.05), hypertension (66.1% vs 39.1% p<0.05), chronic lung disease (20.2% vs 15.1% p<0.05), diabetes (21.7% vs 15% p<0.05), renal failure (11% vs 8.8% p<0.05), coagulopathy (6.2% vs 3.4% p<0.05), and obesity (13.1% vs 8.2% p<0.05) were all risk factors for CAA as compared to those without. It was noted that weight loss (3.28% vs 1.91% p<0.05), electrolyte abnormalities (18.2% vs 15.5% p<0.05), and blood loss (2.1% vs 0.9% p<0.05) were protective of CAA. Conclusion CAA risk factors appear to be similar to those of coronary artery disease risk factors, with hypertension, diabetes, perivascular disease, and renal failure. Additionally, obesity was noted to be a risk factor but weight loss appeared to be protective. Interestingly, Kawasaki disease was seen at almost similar rates as these cardiac risk factors. The incidence of CAA we found, of almost 0.01%, is much less than in the quoted literature, however, previous studies did not have as many cases as our study. Cureus 2019-06-10 /pmc/articles/PMC6687420/ /pubmed/31417821 http://dx.doi.org/10.7759/cureus.4876 Text en Copyright © 2019, Tandon et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Tandon, Varun
Tandon, Aysha A
Kumar, Manish
Mosebach, Christian M
Balakumaran, Kathir
Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title_full Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title_fullStr Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title_full_unstemmed Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title_short Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample
title_sort coronary artery aneurysms: analysis of comorbidities from the national inpatient sample
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687420/
https://www.ncbi.nlm.nih.gov/pubmed/31417821
http://dx.doi.org/10.7759/cureus.4876
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