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

Abstract：

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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Isogai T,Matsui H,Tanaka H,Fushimi K,Yasunaga H

doi

10.1016/j.ijcard.2016.07.159

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

163-170

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(16)31553-4

journal_volume

222

pub_type

杂志文章

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