Percutaneous Coronary Intervention Outcomes Among Patients With Alcoholic Cardiomyopathy: An Analysis of the National Inpatient Sample

Endurance O Evbayekha; Bede N Nriagu; Gabriel Alugba; Okelue E Okobi; Ovie Okorare; Geraldine Nsofor; Ihuoma A Ngoladi; Chinelo Igweike; Maureen G Boms; Nkemputaife P Onyechi; Aisha M Abubakar; Eniola Olamilehin; Akinbanji R Afolabi; Uduak A Udo; Evidence E Ohikhuai

doi:10.7759/cureus.29490

Percutaneous Coronary Intervention Outcomes Among Patients With Alcoholic Cardiomyopathy: An Analysis of the National Inpatient Sample

Cureus. 2022 Sep 23;14(9):e29490. doi: 10.7759/cureus.29490. eCollection 2022 Sep.

Authors

Affiliations

¹ Internal Medicine, St. Luke's Hospital, St. Louis, USA.
² Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York, USA.
³ Internal Medicine, Delta State University, Abraka, NGA.
⁴ Family Medicine, Lakeside Medical Center, Belle Glade, USA.
⁵ Internal Medicine, Milton Keynes University Hospital, Milton Keynes, GBR.
⁶ Family Medicine, Independent Researcher, Calgary, CAN.
⁷ Preventive Medicine, RBH Medical Center, Richmond, USA.
⁸ Clinical Research, University of Alabama at Birmingham, Birmingham, USA.
⁹ Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.
¹⁰ Family Medicine, University of Maiduguri, Maiduguri, NGA.
¹¹ Internal Medicine, St. George's University School of Medicine, St. George's, GRD.
¹² Internal Medicine, Emory University, Atlanta, USA.
¹³ Radiology, Imaging for Women, Kansas City, USA.
¹⁴ Public Health, Jackson State University School of Public Health, Jackson, USA.

Abstract

Introduction High consumption of alcohol has an enormous toll on the health status of individuals. A direct affectation of cardiac integrity concerns cardiologists, primary care physicians, and the healthcare system because this increases the disease burden. Alcoholic cardiomyopathy (ACM) results from the enormous consumption of alcohol over a long period of time. The prevalence varies between regions and sex and ranges between 4% and 40%. Viewing the entire spectrum of cardiomyopathies, ACM makes up about 4% of all cardiomyopathies. However, it causes dilated-type cardiomyopathy and is the second most common cause of dilated cardiomyopathy. We sought to explore the outcomes of percutaneous coronary intervention (PCI) among patients with ACM. Methods This was a retrospective, cross-sectional study of the National Inpatient Sample (NIS) for hospital discharges in the United States between 2012 and 2014. We identified the number of patients with a primary or secondary diagnosis of ACM using the International Classification of Diseases, Ninth Revision (ICD-9) code of 4.255. Using the ICD-9 codes for PCI (00.66, 36.01, 36.02, 36.05, 36.06, 36.07, and 17.55), we identified patients diagnosed with ACM who underwent a PCI (ACPCI). The racial and sexual prevalence, hospital length of stay (LOS), mortality, cost of hospitalization, and cardiovascular outcomes (ventricular fibrillation (VF) and atrial fibrillation (AF)) were compared between patients with and without ACM who underwent a PCI. Results A total of 2,488,293 PCIs were performed between 2012 and 2014. Of these, there were a total of 161 admissions for ACM. About 93% (151) of the ACM PCI group were men. Ethnic distribution revealed a majority of Caucasians with 69% (98), and blacks and Asians at 13.4% (19) and 11.3% (16), respectively. The mean age was 59.8 (SD = 9). The patients with ACPCI were likely to stay longer in the hospital, with an average stay of 6.6 days (SD = 6.2) compared to patients without ACM undergoing PCI (NOACPCI) (3.7 days; SD = 5.0) (p = 0.0001). The mean cost of hospital admission for patients with ACPCI was $120,225 (SD = 101,044), while that of those without ACM who underwent PCI (NOACPCI) was $87,936 (SD = 83,947) (p = 0.0001). A higher death rate during hospitalization (3.7%) was recorded in the ACPCI category vs. 2.3% in patients without ACM who underwent PCI (p = 0.0001). Patients with ACPCI had a higher prevalence of AF (30.4%) than VF (7.5%). Conclusion The ACPCI group had overall poorer hospital outcomes. The majority affected were older Caucasian men with an increased prevalence of AF, higher cost of hospitalization, and longer hospital stays. Further studies are needed to explore the burden of long-term alcohol consumption on cardiovascular disease treatment outcomes.

Keywords: alcohol dependence; alcoholic cardiomyopathy; average length of hospital stay; inpatient outcomes; nationwide inpatient sample (nis); outcome measure; percutaneous coronary intervention; primary percutaneous coronary intervention (pci).