TY - JOUR
T1 - Frequency of Arrhythmias and Postural Orthostatic Tachycardia Syndrome in Patients With Marfan Syndrome
T2 - A Nationwide Inpatient Study
AU - Wafa, Syed Emir Irfan
AU - Chahal, C. Anwar A.
AU - Sawatari, Hiroyuki
AU - Khanji, Mohammed Y.
AU - Khan, Hassan
AU - Asatryan, Babken
AU - Ahmed, Raheel
AU - Deshpande, Saurabh
AU - Providencia, Rui
AU - Deshmukh, Abhishek
AU - Owens, Anjali Tiku
AU - Somers, Virend K.
AU - Padmanabhan, Deepak
AU - Connolly, Heidi
N1 - Publisher Copyright:
© 2022 The Authors and Mayo Foundation for Medical Education and Research.
PY - 2022/9/6
Y1 - 2022/9/6
N2 - BACKGROUND: Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting multiple systems, par-ticularly the cardiovascular system. The leading causes of death in MFS are aortopathies and valvular disease. We wanted to identify the frequency of arrhythmia and postural orthostatic tachycardia syndrome, length of hospital stay, health care– associated costs (HAC), and in-hospital mortality in patients with MFS. METHODS AND RESULTS: The National Inpatient Sample database from 2005 to 2014 was queried using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for MFS and arrhythmias. Patients were classified into subgroups: supraventricular tachycardia, ventricular tachycardia (VT), atrial fibrillation, atrial flutter, and without any type of arrhythmia. Data about length of stay, HAC, and in-hospital mortality were also abstracted from National Inpatient Sample database. Adjusted HAC was calculated as multiplying HAC and cost-to-charge ratio; 12 079 MFS hospitalizations were identified; 1893 patients (15.7%) had an arrhythmia; and 4.9% of the patients had postural orthostatic tachycardia syndrome. Median values of length of stay and adjusted HAC in VT group were the highest among the groups (VT: 6 days, $18 975.8; supraventricular tachycardia: 4 days, $11 906.6; atrial flutter: 4 days, $11 274.5; atrial fibrillation: 5 days, $10431.4; without any type of arrhythmia: 4 days, $8336.6; both P=0.0001). VT group had highest in-patient mortality (VT: 5.3%, atrial fibrillation: 4.1%, without any type of arrhythmia: 2.1%, atrial flutter: 1.7%, supraventricular tachycardia: 0%; P<0.0001) even after adjust-ment for potential confounders (without any type of arrhythmia versus VT; odds ratio [95% CI]: 3.18 [1.62– 6.24], P=0.001). CONCLUSIONS: Arrhythmias and postural orthostatic tachycardia syndrome in MFS were high and associated with increased length of stay, HAC, and in-hospital mortality especially in patients with VT.
AB - BACKGROUND: Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting multiple systems, par-ticularly the cardiovascular system. The leading causes of death in MFS are aortopathies and valvular disease. We wanted to identify the frequency of arrhythmia and postural orthostatic tachycardia syndrome, length of hospital stay, health care– associated costs (HAC), and in-hospital mortality in patients with MFS. METHODS AND RESULTS: The National Inpatient Sample database from 2005 to 2014 was queried using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for MFS and arrhythmias. Patients were classified into subgroups: supraventricular tachycardia, ventricular tachycardia (VT), atrial fibrillation, atrial flutter, and without any type of arrhythmia. Data about length of stay, HAC, and in-hospital mortality were also abstracted from National Inpatient Sample database. Adjusted HAC was calculated as multiplying HAC and cost-to-charge ratio; 12 079 MFS hospitalizations were identified; 1893 patients (15.7%) had an arrhythmia; and 4.9% of the patients had postural orthostatic tachycardia syndrome. Median values of length of stay and adjusted HAC in VT group were the highest among the groups (VT: 6 days, $18 975.8; supraventricular tachycardia: 4 days, $11 906.6; atrial flutter: 4 days, $11 274.5; atrial fibrillation: 5 days, $10431.4; without any type of arrhythmia: 4 days, $8336.6; both P=0.0001). VT group had highest in-patient mortality (VT: 5.3%, atrial fibrillation: 4.1%, without any type of arrhythmia: 2.1%, atrial flutter: 1.7%, supraventricular tachycardia: 0%; P<0.0001) even after adjust-ment for potential confounders (without any type of arrhythmia versus VT; odds ratio [95% CI]: 3.18 [1.62– 6.24], P=0.001). CONCLUSIONS: Arrhythmias and postural orthostatic tachycardia syndrome in MFS were high and associated with increased length of stay, HAC, and in-hospital mortality especially in patients with VT.
KW - Marfan syndrome
KW - cardiac arrhythmia
KW - hospitalization
KW - postural orthostatic tachycardia syndrome
KW - ventricular arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85137547000&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85137547000&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.024939
DO - 10.1161/JAHA.121.024939
M3 - Article
C2 - 36000435
AN - SCOPUS:85137547000
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 17
M1 - e024939
ER -