Outcomes of Percutaneous Coronary Intervention in Patients With Cirrhosis

Kolte, Dhaval; Khera, Sahil; Sharma, Nisha; Aronow, Wilbert S.; Mujib, Marjan; Palaniswamy, Chandrasekar; Jain, Diwakar; Sule, Sachin; Frishman, William H.; Ahmed, Ali; Fonarow, Gregg C.; Panza, Julio A.

doi:10.1016/s0735-1097(14)61852-0

Cited by 2 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, AKI and post-PCI stroke events were reported to be higher in the cirrhotic group in comparison to the non-cirrhotic group by Alqahtani et al and Lu et al, and the results were concordant with our findings [ 21 , 23 ]. Another study conducted by Kolte et al, using national inpatient sampling (NIS) from 2003–2011, reported a higher incidence rate of in-hospital mortality and gastrointestinal bleeding in the post-PCI cirrhotic group in comparison to non-cirrhotic patients, thus supporting the findings of our study [ 24 ].…”

Section: Discussionsupporting

confidence: 91%

Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Khandait

Jaiswal²,

Hanif

et al. 2023

JCDD

View full text Add to dashboard Cite

There is a paucity of data and minimal literature on outcomes of percutaneous coronary intervention (PCI) among liver cirrhosis patients. Therefore, we conducted a systematic review and meta-analysis to evaluate the clinical outcomes among liver cirrhosis patients post-PCI. We conducted a comprehensive literature search in the PubMed, Embase, Cochrane, and Scopus databases for relevant studies. Effect sizes were pooled using the DerSimonian and Laird random-effects model as an odds ratio (OR) with 95% confidence intervals (CI). A total of 3 studies met the inclusion criteria, providing data from 10,705,976 patients. A total of 28,100 patients were in the PCI + Cirrhosis group and 10,677,876 patients were in the PCI-only group. The mean age of patients with PCI + Cirrhosis and PCI alone was 63.45 and 64.35 years. The most common comorbidity was hypertension among the PCI + Cirrhosis group compared with PCI alone (68.15% vs. 73.6%). Cirrhosis patients post-PCI were had higher rates of in-hospital mortality (OR, 4.78 (95%CI: 3.39–6.75), p < 0.001), GI bleeding (OR, 1.91 (95%CI:1.83–1.99), p < 0.001, I2 = 0%), stroke (OR, 2.48 (95%CI:1.68–3.66), p < 0.001), AKI (OR, 3.66 (95%CI: 2.33–6.02), p < 0.001), and vascular complications (OR, 1.50 (95%CI: 1.13–1.98), p < 0.001) compared with the PCI group without cirrhosis. Patients with cirrhosis are at a high risk for mortality and adverse outcomes post-PCI procedure compared to the PCI-only group of patients.

show abstract

Section: Discussionsupporting

confidence: 91%

Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Khandait

Jaiswal²,

Hanif

et al. 2023

JCDD

View full text Add to dashboard Cite

show abstract

“…Expectedly, patients with cirrhosis and end-stage liver disease who undergo PCI and CABG have a higher risk of complications as well as mortality. [12][13][14]19,20 Similar to the findings seen in cirrhosis, patients with CLD have many of these co-morbidities and thus are also at an increased risk of complications. This can lead to a 'risk-aversion' tendency among treating physicians leading to lower utilization of invasive procedures in patients with CLD.…”

Section: Discussionmentioning

confidence: 80%

“…Additionally, these patients with a higher rate of renal dysfunction have an increased risk of developing contrast‐induced nephropathy when undergoing invasive management. Expectedly, patients with cirrhosis and end‐stage liver disease who undergo PCI and CABG have a higher risk of complications as well as mortality 12‐14,19,20 . Similar to the findings seen in cirrhosis, patients with CLD have many of these co‐morbidities and thus are also at an increased risk of complications.…”

Section: Discussionmentioning

confidence: 93%

“…[9][10][11][12] They may be less likely to receive guideline-recommended management in the form of percutaneous coronary intervention (PCI) and dual-antiplatelet therapy (DAPT) due to these increased risks. [13][14][15][16] There are limited data on management strategies and clinical outcomes for this high-risk group when presenting with AMI from a national perspective. While there have been small studies on the utilization of invasive therapies and outcomes in a subset of such patients (eg ST-elevation myocardial infarction (STEMI) or AMI patients with cirrhosis), 1,2 these outcomes have not been systematically evaluated across CLD sub-groups.…”

Section: Introductionmentioning

confidence: 99%

“…While their risk of cardiovascular mortality is at least as high as patients without CLD, they are at an inherent risk of major bleeding complications due to risk factors such as anaemia, thrombocytopenia, decreased clotting factor synthesis, increased fibrinolysis and renal impairment 9‐12 . They may be less likely to receive guideline‐recommended management in the form of percutaneous coronary intervention (PCI) and dual‐antiplatelet therapy (DAPT) due to these increased risks 13‐16 . There are limited data on management strategies and clinical outcomes for this high‐risk group when presenting with AMI from a national perspective.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trends, management and outcomes of acute myocardial infarction in chronic liver disease

et al. 2020

View full text Add to dashboard Cite

Aims There are limited data on the management and outcomes of chronic liver disease (CLD) patients presenting with acute myocardial infarction (AMI), particularly according to the subtype of CLD. Methods Using the Nationwide Inpatient Sample (2004‐2015), we examined outcomes of AMI patients stratified by severity and sub‐types of CLD. Multivariable logistic regression was performed to assess the adjusted odds ratios (aOR) of receipt of invasive management and adverse outcomes in CLD groups compared with no‐CLD. Results Of 7 024 723 AMI admissions, 54 283 (0.8%) had a CLD diagnosis. CLD patients were less likely to undergo coronary angiography (CA) and percutaneous coronary intervention (PCI) (aOR 0.62, 95%CI 0.60‐0.63 and 0.59, 95%CI 0.58‐0.60, respectively), and had increased odds of adverse outcomes including major adverse cardiovascular and cerebrovascular events (1.19, 95%CI 1.15‐1.23), mortality (1.30, 95%CI 1.25‐1.34) and major bleeding (1.74, 95%CI 1.67‐1.81). In comparison to the non‐severe CLD sub‐groups, patients with all forms of severe CLD had the lower utilization of CA and PCI (P < .05). Among severe CLD patients, those with alcohol‐related liver disease (ALD) had the lowest utilization of CA and PCI; patients with ALD and other CLD (OCLD) had more adverse outcomes than the viral hepatitis sub‐group (P < .05). Conclusions CLD patients presenting with AMI are less likely to receive invasive management and are associated with worse clinical outcomes. Further differences are observed depending on the type as well as severity of CLD, with the worst management and clinical outcomes observed in those with severe ALD and OCLD.

show abstract

Outcomes of Percutaneous Coronary Intervention in Patients With Cirrhosis

Cited by 2 publications

References 0 publications

Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Trends, management and outcomes of acute myocardial infarction in chronic liver disease

Contact Info

Product

Resources

About