Abstract

Introduction: Percutaneous coronary intervention (PCI) is associated with an increased risk of cholesterol embolization syndrome (CES), accounting for approximately 70% of iatrogenic cholesterol embolization. The clinical outcomes of patients with acute coronary syndrome (ACS), who develop CES post-PCI is yet to be explored on a national scale. Objectives: To evaluate the length of hospital stay (LOS), cost of hospitalization; proportion of patients with acute kidney injury (AKI), sepsis, cardiogenic shock and in-hospital mortality among those with ACS who develop CES post-PCI. Methods: Adults who had a diagnosis of ACS and PCI done who eventually had CES, were identified from the National In-Patient Sample (NIS) dataset between 2016-2018 using ICD10 codes. Weighted multivariable logistic and linear regression models were used as appropriate. Various sociodemographic, clinical and hospital level factors were adjusted for in the analysis. Results: Of the 365 patients who had ACS and developed CES post-PCI; 48% were women, 76.7% were non-Hispanic White and the average age was 69.5 years. The mean LOS was 8.2 days and the mean cost of hospitalization was $99,958.02. Overall, 32.9% of the patients developed AKI, 6.8% developed sepsis, 4.1% subsequently had cardiogenic shock and 11% had in-hospital mortality. Conclusions: Our study highlights important patient characteristics, resource utilization and clinical outcomes among patients with ACS who develop CES post-PCI, which provides relevant information needed to generate hypothesis linked to this disease condition.

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