Temporal variation in inhospital mortality with percutaneous coronary intervention: A report from the National Heart, Lung and Blood Institute Dynamic Registry

Warren K. Laskey, Faith Selzer, David R. Holmes, Robert L. Wilensky, Howard A. Cohen, David O. Williams, Kevin E. Kip, Katherine M. Detre

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Cardiovascular morbidity and mortality display a distinct time dependence also known as circadian variation. Whether such time dependence extends to the risk of procedural-related mortality after percutaneous coronary intervention (PCI) is presently unknown. Methods: Inhospital mortality was analyzed in 6347 patients with PCI start times from 8:00 am to 6:59 pm ("usual" workday). The sample was divided into 3 evenly populated groups (morning start 8:00-10:59 am, midday start 11:00 am-1:59 pm, afternoon start 2:00-6:59 pm). The association between procedural start time and mortality was assessed using multivariable analysis including a propensity score accounting for factors associated with procedural start time. Results: There was a significant, nonlinear relationship between procedural-related mortality and start time (P = .03). Afternoon start patients were at higher adjusted risk of mortality compared with midday start patients (OR 2.03, 95% CI 1.07-3.83, P = .03 ). Morning start patients were also at higher risk compared with midday start patients although the association was not statistically significant (OR 1.73, 95% CI 0.89-3.39, P = .11). Conclusions: There is a significant time-dependent variation in the risk of inhospital PCI-related mortality during usual working hours. The highest risk period, taking into account numerous factors that confound this association, is the latter part of the workday. A second period of apparent greater risk occurs during the early part of the workday and is consistent with our present understanding of circadian variation in cardiovascular disease processes.

Original languageEnglish (US)
Pages (from-to)569-576
Number of pages8
JournalAmerican Heart Journal
Volume150
Issue number3
DOIs
StatePublished - Sep 1 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Temporal variation in inhospital mortality with percutaneous coronary intervention: A report from the National Heart, Lung and Blood Institute Dynamic Registry'. Together they form a unique fingerprint.

  • Cite this