Outcomes of Acute Myocardial Infarction in Patients with Surgically Replaced Heart Valve

Background
Limited data available on the outcomes of acute myocardial infarction (AMI) in patients with a history of a surgically replaced heart valve (SRHV) in comparison to the general population (non-SRHV).

Methods
The study population was extracted from the 2014 Nationwide Readmissions Data using International Classification of Diseases, Ninth Revision, Clinical Modification codes for AMI, SRHV, and in-hospital outcomes. Study outcomes included in-hospital all-cause mortality, length of hospital stay (LOS), cardiogenic shock, bleeding, vascular complications, acute kidney injury, the likelihood of receiving invasive left heart catheterization with/without percutaneous coronary intervention (PCI).

Results
A total of 259,794 discharges with a principal diagnosis of AMI were identified, among which 1397 had a history of SRHV. Mean age 67.4 years, 38% female. In comparison to non-SRHV, SRHV group was associated with increased in-hospital all-cause mortality (9.3% versus 5.4%, p<0.01), longer LOS (18.8 versus 4.9 days, p<0.01), more cardiogenic shock (24.0% versus 6.3%, p<0.01), bleeding (50.3% versus 6.6%, p<0.01), vascular complications (2.4% versus 0.8%, p<0.01), acute kidney injury (40.2% versus 17.5%, p<0.01). SRHV group was more likely to be treated invasively (85.2% versus 75.0%, p<0.01), however, it received fewer PCI (7.2% versus 50.2%, p<0.01).

Conclusions
Compared with non-SRHV, SRHV presented with AMI was associated with increased in-hospital all-cause mortality, longer LOS, and more in-hospital morbidity. Although SRHV group was more likely to be treated invasively, it received fewer PCI.