Atrial natriuretic peptide therapy and in-hospital mortality in acute myocardial infarction patients undergoing percutaneous coronary intervention

被引:11
|
作者
Isogai, Toshiaki [1 ,2 ]
Matsui, Hiroki [1 ]
Tanaka, Hiroyuki [2 ]
Fushimi, Kiyohide [3 ]
Yasunaga, Hideo [1 ]
机构
[1] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan
[2] Tokyo Metropolitan Tama Med Ctr, Dept Cardiol, 2-8-29 Musashidai, Fuchu, Tokyo 1838524, Japan
[3] Tokyo Med & Dent Univ, Grad Sch Med, Dept Hlth Policy & Informat, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138510, Japan
关键词
Atrial natriuretic peptide; Acute myocardial infarction; Percutaneous coronary intervention; In-hospital mortality; WORSENING RENAL-FUNCTION; ST-ELEVATION; OUTCOMES; PREDICTORS; NESIRITIDE; TRENDS; INJURY;
D O I
10.1016/j.ijcard.2016.07.159
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Atrial natriuretic peptide (ANP) therapy has been reported to have beneficial effects in patients with acute myocardial infarction (AMI); however, its impact on in-hospital mortality remains unclear. This study aimed to investigate the effects of ANP therapy on in-hospital mortality in AMI patients undergoing percutaneous coronary intervention (PCI). Methods: This was a retrospective cohort study using the Diagnosis Procedure Combination inpatient database in Japan. We identified AMI patients who underwent PCI with stent implantation on the day of admission, between 2010 and 2014. We compared 30-day in-hospital mortality between patients who started ANP therapy on the day of admission (ANP group) and those who received no ANP therapy during hospitalization (control group), using propensity score and instrumental variable methods. Results: Of 60,592 eligible patients (8189 ANP group, 52,403 control group) from 850 hospitals, 1: 1 propensity score matching created 8027 pairs. There was no significant difference in 30-day in-hospital mortality between the ANP and control groups (3.4% vs. 3.8%, respectively; p = 0.162; risk difference, -0.42%; 95% confidence interval [CI],- 1.00% to 0.15%) in the propensity score-matched cohort. Logistic regression analysis with adjustment for propensity score deciles found no significant association between ANP therapy and 30-day in-hospital mortality (odds ratio, 0.99; 95% CI, 0.82 to 1.19). Instrumental variable analysis also showed no significant association between ANP therapy and 30-day in-hospital mortality (risk difference, -0.59%; 95% CI, -1.24% to 0.05%). Conclusions: This study found no significant association between ANP therapy and in-hospital mortality in AMI patients undergoing PCI. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:163 / 170
页数:8
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