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P681Acute Myocardial Infarction in patients with Leukaemia: A national analysis of prevalence, predictors and outcomes in United States hospitalisations (2004 to 2014)

Mohamed, M O; Lopez-Mattei, J C; Iliescu, C A; Purwani, P; Bharadwaj, A; Kim, P Y; Palaskas, N L; Rashid, M; Potts, J E; Kwok, C S; Gulati, M; Al Zubaidi, A B; Mamas, M

Authors

M O Mohamed

J C Lopez-Mattei

C A Iliescu

P Purwani

A Bharadwaj

P Y Kim

N L Palaskas

C S Kwok

M Gulati

A B Al Zubaidi



Abstract

Background
Patients with leukaemia are at increased risk of cardiovascular events. There is limited outcomes data for patients with a history of leukaemia who present with an acute myocardial infarction (AMI).

Purpose
To examine the prevalence and clinical characteristics of patients with leukaemia presenting with AMI, and evaluate differences in clinical outcomes according to the subtype of leukaemia in comparison to patients without leukaemia.

Methods
We analysed the Nationwide Inpatient Sample (2004–2014) for patients with a primary discharge diagnosis of AMI and concomitant leukaemia, and further stratified according to the subtype of leukaemia into 4 groups; AML; ALL; CML; and CLL. Multiple logistic regression was conducted to identify the association between leukaemia and major acute cardiovascular and cerebrovascular events (MACCE; composite of mortality, stroke and cardiac complications) and bleeding.

Results
Out of 6,750,927 AMI admissions, a total of 21,694 patients had a leukaemia diagnosis. The leukaemia group experienced higher rates of MACCE (11.8% vs. 7.8%), mortality (10.3% vs. 5.8%) and bleeding (5.6% vs. 5.3%). Following adjustments, leukaemia was independently associated with increased odds of MACCE (OR 1.26 [1.20,1.31]) and mortality (OR 1.43 [1.37,1.50]) without an increased risk of bleeding (OR 0.86 [0.81,0.92]). Acute myeloid leukaemia (AML) was associated with approximately three-fold risk of MACCE (RR 2.81 [2.51, 3.13]) and a four-fold risk of mortality (RR 3.75 [3.34, 4.22]) (Figure 1). Patients with leukaemia were less likely to undergo coronary angiography (CA) (48.5% vs. 64.5%) and percutaneous coronary intervention (PCI) (28.2% vs. 42.9%) compared to those without leukaemia.

Citation

Mohamed, M. O., Lopez-Mattei, J. C., Iliescu, C. A., Purwani, P., Bharadwaj, A., Kim, P. Y., …Mamas, M. (2019). P681Acute Myocardial Infarction in patients with Leukaemia: A national analysis of prevalence, predictors and outcomes in United States hospitalisations (2004 to 2014). European Heart Journal, 40(Supplement_1), https://doi.org/10.1093/eurheartj/ehz747.0287

Journal Article Type Conference Paper
Online Publication Date Oct 21, 2019
Publication Date Oct 1, 2019
Deposit Date Jun 20, 2023
Journal European Heart Journal
Print ISSN 0195-668X
Electronic ISSN 1522-9645
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 40
Issue Supplement_1
DOI https://doi.org/10.1093/eurheartj/ehz747.0287
Keywords Cardiology and Cardiovascular Medicine