Background
Methods
Results
Variable | Inotropes | No Inotropes | p Value |
---|---|---|---|
Demographics | |||
Total number, n (%) | 858 (10.6) | 7208 (89.4) | |
Age, mean (SD) | 63 ± 12 | 62 ± 12 | 0.04 |
Male, n (%) | 419 (61.1) | 4270 (66.9) | 0.001 |
Middle-Eastern Arabs | 674 (78.6) | 5472 (73.7) | |
South Asians | 164 (19.1) | 1562 (21.7) | |
Others | 20 (2.3) | 174 (2.4) | 0.001 |
Patient Characteristics, n (%) | |||
Smoker | 141 (16.4) | 1043 (14.5) | 0.12 |
Chronic renal impairment | 158 (18.4) | 612 (8.5) | 0.001 |
Dyslipidemia | 96 (11.2) | 394 (5.5) | 0.001 |
Hypertension | 595 (69.3) | 4100 (56.9) | 0.001 |
Diabetes Mellitus | 569 (66.3) | 4115 (57.1) | 0.001 |
Obesity | 75 (8.7) | 443 (6.1) | 0.003 |
Menopause | 34 (4) | 206 (2.9) | 0.07 |
Labs, mean (SD) | |||
Hemoglobin (g/dl) | 11.8 ± 5 | 12 ± 4.9 | 0.04 |
Fasting blood sugar, mmol/L | 11 ± 16 | 12 ± 48 | 0.81 |
Serum creatinine, mmol/L | 164 ± 127 | 131 ± 265 | 0.01 |
BNP, (pg/ml) | 4195 ± 7450 | 3090 ± 7650 | 0.22 |
Cholesterol, mmol/L | 4.3 ± 1.5 | 4.4 ± 6 | 0.57 |
Low density lipoprotein (LDL), mmol/L | 2.46 ± 1.0 | 2.9 ± 9.8 | 0.42 |
High density lipoprotein (HDL), mmol/L | 1.2 ± 1.6 | 1.6 ± 1.9 | 0.63 |
Triglycerides, mmol/L | 1.6 ± 1.3 | 1.6 ± 7.8 | 0.98 |
Creatinine kinase -MB, μ/L | 61 ± 192 | 74 ± 559 | 0.6 |
Labs, n (%) | |||
Troponin positive | 350 (40.8) | 1866 (25.9) | 0.001 |
Cardiac History, n (%) | |||
Admission ejection fraction ≤ 40 % | 200 (59.2) | 1305 (69.6) | 0.001 |
Rheumatic heart disease | 3 (0.3) | 43 (0.6) | 0.36 |
ST-elevation myocardial infarction (STEMI) | 74 (8.6) | 309 (4.3) | 0.001 |
Non-STEMI (NSTEMI) | 53 (6.2) | 256 (3.6) | 0.001 |
Unstable angina | 64 (7.5) | 421 (5.8) | 0.06 |
Cardiomyopathy | 125 (14.6) | 860 (11.9) | 0.03 |
Pulmonary hypertension | 12 (1.4) | 80 (1.1) | 0.45 |
Valvular Heart Disease, n (%) | |||
Mitral regurgitation | 44 (5.1) | 373 (5.2) | 0.95 |
Aortic regurgitation | 11 (1.3) | 106 (1.5) | 0.66 |
Variable | Inotropes | No Inotropes | p Value |
---|---|---|---|
Procedures, n (%) | |||
Intraaortic balloon pump (IABP) | 22 (2.6) | 28 (0.4) | 0.001 |
Swan-Ganz catheterization | 47 (5.5) | 82 (1.1) | 0.001 |
Percutaneous coronary intervention (PCI) | 17 (2) | 54 (0.7) | 0.001 |
Coronary artery bypass grafting (CABG) | 61 (7.1) | 652 (9) | 0.06 |
Intubation | 58 (6.8) | 76 (1.1) | 0.001 |
Dialysis | 16 (1.9) | 22 (0.3) | 0.001 |
Complications, n (%) | |||
Cerebrovascular accident (CVA) | 4 (0.5) | 39 (0.5) | 0.78 |
Left bundle branch block (LBBB) | 29 (3.4) | 223 (3.1) | 0.65 |
Supraventricular tachycardia (SVT) | 3 (0.3) | 13 (0.2) | 0.3 |
Ventricular tachycardia | 17 (2) | 65 (0.9) | 0.003 |
Atrial fibrillation | 53 (6.2) | 726 (10.1) | 0.001 |
Ventricular fibrillation | 5 (0.6) | 10 (0.1) | 0.004 |
Cardiac arrest | 125 (14.6) | 232 (3.2) | 0.001 |
In-hospital mortality | 193 (30.8) | 407 (9.1) | 0.001 |
Complications, mean (SD) | |||
Length of CCU stay | 5 ± 7 | 4 ± 5 | 0.02 |
Total days hospitalized | 8 ± 34 | 5 ± 103 | 0.001 |
Outcome
Trends
Trend in years | 1991–95 | 1996–2000 | 2001–05 | 2006–10 | >2010 | P value |
---|---|---|---|---|---|---|
Inotropic | 65(4.6 %) | 159(9.0 %) | 201(9.9 %) | 277(14.2 %) | 154(17.6 %) | 0.001 |
Support |
Trend in years | 1991–95 | 1996–2000 | 2001–05 | 2006–10 | >2010 | P value |
---|---|---|---|---|---|---|
Mortality | 17.7 % | 27.1 % | 29.2 % | 18.8 % | 7.3 % | 0.001 |
Multivariate analysis
Variable | Adjusted OR | 95 % CI | p value |
---|---|---|---|
Age | 0.99 | 0.98–1.01 | 0.33 |
Male | 0.90 | 0.64–1.27 | 0.55 |
Diabetes Mellitus | 1.04 | 0.72–1.50 | 0.84 |
Hypertension | 1.66 | 1.10–2.50 | 0.02 |
Obesity | 1.06 | 0.66–1.70 | 0.81 |
Chronic renal failure | 1.76 | 1.19–2.60 | 0.005 |
Ejection fraction >40 | 1.92 | 1.27–2.90 | 0.002 |
Middle-Eastern Arabs | 1.10 | 0.76–1.58 | 0.62 |
Old myocardial infarction | 1.19 | 0.82–1.71 | 0.36 |
Variable | Inotropes | No Inotropes | P Value |
---|---|---|---|
ß-blocker | 275 (32.1) | 1908 (26.5) | 0.001 |
ACE/ARBa | 321 (37.4) | 4346 (60.3) | 0.001 |
Calcium channel blockers | 352 (41) | 768 (10.7) | 0.001 |
Digoxin | 28 (3.3) | 389 (5.4) | 0.008 |
Amiodarone | 53 (6.2) | 394 (5.5) | 0.39 |
Frusemide | 545 (63.5) | 6012 (83.4) | 0.001 |
Spiranolactone | 35 (4.1) | 456 (6.3) | 0.009 |