Medical Therapy Versus Percutaneous Coronary Intervention in Patients with Myocardial Bridging from a National Population-Based Cohort Study: The Use of Big Data Analytics
Abstract
:1. Introduction
2. Methods
2.1. Data Source
2.2. Study Population
2.3. Study Outcomes and Definitions
2.4. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Medical Therapy | PCI | Total | p-Value | ||
---|---|---|---|---|---|---|
Number of patients, n | 11,875 | % | 3635 | % | 15,510 | |
Age | 64.53 ± 15.04 | 65.86 ± 12.83 | 0.019 | |||
Female | 3695 | 31.12 | 970 | 26.69 | 4665 | 0.0223 |
Race | 0.0002 | |||||
White | 7595 | 63.96 | 2580 | 70.98 | 10,175 | |
Black | 1705 | 14.36 | 355 | 9.77 | 2060 | |
Hispanic | 1140 | 9.60 | 250 | 6.88 | 1390 | |
Asian or Pacific Islander | 480 | 4.04 | 100 | 2.75 | 580 | |
Native American | 45 | 0.38 | 35 | 0.96 | 80 | |
Other | 430 | 3.62 | 155 | 4.26 | 585 | |
Missing | 480 | 3.62 | 160 | 4.40 | ||
Hospital Bed Size | 0.9295 | |||||
Small | 1920 | 16.17 | 605 | 16.64 | 2525 | |
Medium | 3125 | 26.32 | 935 | 25.72 | 4060 | |
Large | 6830 | 57.52 | 2095 | 57.63 | 8925 | |
Hospital Teaching Status | 0.0071 | |||||
Rural | 520 | 4.38 | 215 | 5.91 | 735 | |
Urban Non-teaching | 2080 | 17.52 | 790 | 21.73 | 2870 | |
Urban Teaching | 9275 | 78.11 | 2630 | 72.35 | 11,905 | |
Admission | ||||||
Elective | 2350 | 19.81 | 485 | 13.36 | 2835 | 0.0001 |
Primary payment coverage | 0.00 | 0.00 | 0.0835 | |||
Medicare | 6695 | 56.38 | 1950 | 53.65 | 8645 | |
Medicaid | 1300 | 10.95 | 300 | 8.25 | 1600 | |
Private insurance | 3130 | 26.36 | 1095 | 30.12 | 4225 | |
Self-pay | 345 | 2.91 | 140 | 3.85 | 485 | |
No charge | 45 | 0.38 | 15 | 0.41 | 60 | |
Other | 350 | 2.95 | 130 | 3.58 | 480 | |
Missing | 10 | 2.95 | 5 | 3.58 | ||
Median household income, USD | 0.231 | |||||
1–28,999 | 3190 | 26.86 | 1000 | 27.51 | 4190 | |
29,000–35,999 | 3115 | 26.23 | 1050 | 28.89 | 4165 | |
36,000–46,999 | 2880 | 24.25 | 760 | 20.91 | 3640 | |
47,000+ | 2425 | 20.42 | 765 | 21.05 | 3640 | |
Missing | 265 | 2.23 | 60 | 1.65 | ||
Hospital Region | 0.3563 | |||||
Northeast | 1805 | 15.20 | 500 | 13.76 | 2305 | |
Midwest | 3020 | 25.43 | 840 | 23.11 | 3860 | |
South | 4615 | 38.86 | 1530 | 42.09 | 6145 | |
West | 2435 | 20.51 | 765 | 21.05 | 3200 | |
Comorbidities | ||||||
Congestive heart failure | 4995 | 42.06 | 1480 | 40.72 | 6475 | 0.5264 |
Cardiac arrhythmias | 5790 | 48.76 | 1520 | 41.82 | 7310 | 0.0012 |
Valvular heart diseases | 2725 | 22.95 | 520 | 14.31 | 3245 | <0.001 |
Pulmonary circulatory disorders | 1235 | 10.40 | 245 | 6.74 | 1480 | 0.0036 |
Peripheral vascular disease | 2610 | 21.98 | 545 | 14.99 | 3155 | <0.001 |
HTN, uncomplicated | 4765 | 40.13 | 1805 | 49.66 | 6570 | <0.001 |
HTN, complicated | 4835 | 40.72 | 1225 | 33.70 | 6060 | 0.0008 |
Paralysis | 170 | 1.43 | 30 | 0.83 | 200 | 0.2055 |
Other neurologic disorders | 1050 | 8.84 | 200 | 5.50 | 1250 | 0.0042 |
Chronic lung disease | 3135 | 26.40 | 675 | 18.57 | 3810 | <0.001 |
DM, uncomplicated | 1545 | 13.01 | 635 | 17.47 | 2180 | 0.0026 |
DM, complicated | 2020 | 17.01 | 625 | 17.19 | 2645 | 0.9101 |
Hypothyroidism | 1430 | 12.04 | 415 | 11.42 | 1845 | 0.6506 |
CKD | 2675 | 22.53 | 630 | 17.33 | 3305 | 0.0027 |
Liver disease | 545 | 4.59 | 210 | 5.78 | 755 | 0.1937 |
Peptic ulcer disease | 100 | 0.84 | 15 | 0.41 | 115 | 0.2386 |
Lymphoma | 55 | 0.46 | 15 | 0.41 | 70 | 0.8586 |
Metastatic cancer | 130 | 1.09 | 40 | 1.10 | 170 | 0.9897 |
Solid tumor | 390 | 3.28 | 95 | 2.61 | 485 | 0.3693 |
Rheumatologic disorders | 800 | 6.74 | 130 | 3.58 | 930 | 0.0018 |
Coagulopathy | 1465 | 12.34 | 225 | 6.19 | 1690 | 0 |
Obesity | 2525 | 21.26 | 775 | 21.32 | 3300 | 0.9743 |
Weight loss | 580 | 4.88 | 50 | 1.38 | 630 | <0.001 |
Fluid and electrolyte disorders | 3660 | 30.82 | 805 | 22.15 | 4465 | <0.001 |
Blood loss anemia | 85 | 0.72 | 30 | 0.83 | 115 | 0.7635 |
Deficiency anemia | 475 | 4.00 | 130 | 3.58 | 605 | 0.606 |
Alcohol abuse | 450 | 3.79 | 115 | 3.16 | 565 | 0.4317 |
Drug abuse | 500 | 4.21 | 170 | 4.68 | 670 | 0.5964 |
Psychoses | - | - | - | - | - | - |
Depression | 1225 | 10.32 | 310 | 8.53 | 1535 | 0.1562 |
Smoking | 2280 | 19.20 | 1005 | 27.65 | 3285 | <0.001 |
Prior MI | 2400 | 20.21 | 725 | 19.94 | 3125 | 0.8779 |
Prior PCI | 170 | 1.43 | 35 | 0.96 | 205 | 0.332 |
Prior CABG | 1055 | 8.88 | 205 | 5.64 | 1260 | 0.1462 |
AMI | 3520 | 29.64 | 2650 | 72.90 | 6170 | <0.001 |
Outcomes | Medical Therapy | PCI | p-Value | Adjusted OR | Lower Limit | Upper Limit | p-Value | ||
---|---|---|---|---|---|---|---|---|---|
Number of patients | 11,875 | % | 3635 | % | |||||
Mortality | 325 | 2.74 | 165 | 4.54 | 0.0151 | 1.39 | 0.81 | 2.40 | 0.232 |
Cardiac arrest | 290 | 2.44 | 145 | 3.99 | 0.0285 | 1.68 | 0.94 | 3.03 | 0.083 |
Cardiogenic shock | 590 | 4.97 | 365 | 10.04 | 0 | 2.04 | 1.40 | 2.99 | 0 |
Use of MCS | |||||||||
LVAD | 45 | 0.38 | 170 | 4.68 | 0 | 15.22 | 5.54 | 41.79 | 0 |
IABP | 230 | 1.94 | 245 | 6.74 | 0 | 2.24 | 1.34 | 3.74 | 0.002 |
ECMO | 30 | 0.25 | 15 | 0.41 | 0.5055 | - | - | - | - |
AKI | 2370 | 19.96 | 595 | 16.37 | 0.0317 | 0.93 | 0.70 | 1.23 | 0.595 |
Cost of hospitalization, USD | 27,787 ± 32,418 | - | 30,884 ± 25,100 | - | 0.009 | - | - | - | - |
Length of stay, days | 6.13 ± 6.57 | - | 4.53 ± 5.25 | - | <0.001 | - | - | - | - |
Variables | Odds Ratio | Lower Limit | Upper Limit | p-Value |
---|---|---|---|---|
Smoking | 1.61 | 1.31 | 1.97 | 0 |
Prior MI | 0.77 | 0.62 | 0.95 | 0.015 |
Depression | 0.66 | 0.49 | 0.88 | 0.004 |
Prior CABG | 0.57 | 0.40 | 0.80 | 0.001 |
Psychosis | 0.35 | 0.10 | 1.27 | 0.11 |
Drug abuse | 0.95 | 0.63 | 1.43 | 0.797 |
Nutrional deficiency anemia | 0.84 | 0.54 | 1.31 | 0.435 |
Blood loss anemia | 0.74 | 0.26 | 2.11 | 0.568 |
Weight loss | 0.43 | 0.26 | 0.70 | 0.001 |
Coagulopathy | 0.84 | 0.64 | 1.12 | 0.232 |
Rheumatological disorders | 0.92 | 0.65 | 1.30 | 0.64 |
Lymphoma | 0.27 | 0.05 | 1.50 | 0.135 |
Peptic ulcer disease | 0.26 | 0.07 | 1.01 | 0.051 |
CKD | 0.74 | 0.58 | 0.95 | 0.019 |
Hypothyroidism | 0.88 | 0.67 | 1.15 | 0.334 |
Diabetes, uncomplicated | 1.16 | 0.91 | 1.48 | 0.223 |
Chronic lung disease | 0.65 | 0.52 | 0.80 | 0 |
Other neurological disorders | 0.72 | 0.53 | 0.99 | 0.045 |
Hypertension, complicated | 1.32 | 1.03 | 1.70 | 0.027 |
Hypertension, uncomplicated | 1.11 | 0.89 | 1.37 | 0.366 |
Peripheral vascular disease | 0.69 | 0.56 | 0.86 | 0.001 |
Pulmonary circulatory disorders | 0.55 | 0.40 | 0.76 | 0 |
Valvular heart diseases | 0.82 | 0.66 | 1.02 | 0.07 |
Cardiac arrhythmia | 0.85 | 0.72 | 1.01 | 0.062 |
Median household income | ||||
1–28,999 | Ref | |||
29,000–35,999 | 1.17 | 0.94 | 1.47 | 0.163 |
36,000–46,999 | 0.91 | 0.72 | 1.14 | 0.408 |
47,000+ | 0.93 | 0.72 | 1.19 | 0.565 |
Elective admission | 0.17 | 0.13 | 0.23 | 0 |
Primary payer method | ||||
Medicare | Ref | |||
Medicaid | 1.00 | 0.72 | 1.38 | 0.977 |
Private insurance | 1.48 | 1.19 | 1.86 | 0.001 |
Self-pay | 1.49 | 0.90 | 2.47 | 0.12 |
No charge | 1.01 | 0.28 | 3.61 | 0.988 |
Other | 2.06 | 1.30 | 3.27 | 0.002 |
Hospital region | ||||
Northeast | Ref | |||
Midwest | 1.14 | 0.87 | 1.50 | 0.349 |
South | 1.05 | 0.82 | 1.36 | 0.683 |
West | 1.46 | 1.10 | 1.93 | 0.008 |
Hospital teaching status | ||||
Rural | Ref | |||
Urban Non-teaching | 0.70 | 0.46 | 1.05 | 0.085 |
Urban Teaching | 0.69 | 0.47 | 1.01 | 0.058 |
Hospital bed size | ||||
Small | Ref | |||
Medium | 0.85 | 0.66 | 1.11 | 0.242 |
Large | 0.82 | 0.64 | 1.04 | 0.1 |
Race | ||||
White | Ref | |||
Black | 0.79 | 0.62 | 1.02 | 0.067 |
Hispanic | 0.84 | 0.63 | 1.13 | 0.25 |
Asian or Pacific Islander | 1.04 | 0.70 | 1.55 | 0.838 |
Native American | 3.76 | 1.22 | 11.56 | 0.021 |
Other | 0.85 | 0.54 | 1.33 | 0.472 |
Female | 0.75 | 0.62 | 0.91 | 0.003 |
Age | 1.01 | 1.00 | 1.02 | 0.031 |
Mortality | Odds Ratio | Lower Limit | Upper Limit | p-Value |
---|---|---|---|---|
AMI | 4.09 | 2.58 | 6.49 | <0.001 |
Drug abuse | 0.60 | 0.17 | 2.07 | 0.418 |
Blood loss anemia | 0.86 | 0.12 | 5.96 | 0.876 |
Fluid and electrolyte disorders | 2.28 | 1.45 | 3.59 | <0.001 |
Obesity | 0.42 | 0.21 | 0.82 | 0.011 |
Coagulopathy | 1.81 | 1.07 | 3.07 | 0.027 |
Peptic ulcer disease | 5.23 | 1.11 | 24.62 | 0.036 |
Liver disease | 4.76 | 2.63 | 8.59 | <0.001 |
CKD | 2.32 | 1.29 | 4.19 | 0.005 |
Other neurological disorders | 3.32 | 1.96 | 5.60 | <0.001 |
Hypertension, complicated | 0.53 | 0.25 | 1.11 | 0.094 |
Hypertension, uncomplicated | 0.94 | 0.46 | 1.91 | 0.867 |
Cardiac arrhythmias | 2.53 | 1.54 | 4.16 | <0.001 |
Congestive heart failure | 1.83 | 1.04 | 3.24 | 0.037 |
Hospital region | ||||
Northeast | ||||
Midwest | 1.13 | 0.55 | 2.33 | 0.734 |
South | 1.13 | 0.57 | 2.22 | 0.726 |
West | 1.29 | 0.62 | 2.67 | 0.496 |
Age | 1.02 | 1.00 | 1.03 | 0.091 |
Variables | Odds Ratio | Lower Limit | Upper Limit | p-Value |
---|---|---|---|---|
AMI | 3.44 | 1.90 | 6.24 | 0 |
Prior MI | 0.51 | 0.21 | 1.26 | 0.146 |
Prior PCI | 2.16 | 0.24 | 19.35 | 0.491 |
Depression | 0.51 | 0.13 | 1.92 | 0.317 |
Fluid and electrolyte disorders | 2.02 | 1.15 | 3.54 | 0.014 |
Obesity | 0.41 | 0.16 | 1.02 | 0.055 |
Coagulopathy | 1.87 | 0.98 | 3.58 | 0.059 |
Solid tumour | 1.00 | |||
Liver disease | 3.09 | 1.33 | 7.14 | 0.009 |
CKD | 1.90 | 0.98 | 3.70 | 0.059 |
Other neurological disorders | 3.67 | 1.82 | 7.40 | 0 |
Hypertension, uncomplicated | 1.22 | 0.54 | 2.74 | 0.637 |
Peripheral vascular disease | 1.67 | 0.95 | 2.95 | 0.076 |
Pulmonary circulatory disorders | 1.16 | 0.49 | 2.77 | 0.738 |
Valvular heart diseases | 1.16 | 0.64 | 2.11 | 0.615 |
Cardiac arrhythmias | 2.85 | 1.50 | 5.44 | 0.001 |
Congestive heart failure | 1.18 | 0.60 | 2.32 | 0.642 |
Median household income | ||||
1–28,999 | ||||
29,000–35,999 | 0.62 | 0.30 | 1.32 | 0.215 |
36,000–46,999 | 0.79 | 0.39 | 1.60 | 0.509 |
47,000+ | 0.44 | 0.18 | 1.08 | 0.074 |
Elective | 0.45 | 0.16 | 1.28 | 0.137 |
Hospital bed size | ||||
Small | Ref | |||
Medium | 3.16 | 1.14 | 8.75 | 0.027 |
Large | 1.90 | 0.73 | 4.94 | 0.188 |
Age | 1.02 | 0.99 | 1.04 | 0.204 |
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Krittanawong, C.; Ang, S.P.; Padilla, F.A.; Qadeer, Y.K.; Wang, Z.; Gaibazzi, N.; Sharma, S.K.; Lavie, C.J.; Schaff, H.V.; Schwarz, E.R. Medical Therapy Versus Percutaneous Coronary Intervention in Patients with Myocardial Bridging from a National Population-Based Cohort Study: The Use of Big Data Analytics. Cardiogenetics 2025, 15, 10. https://doi.org/10.3390/cardiogenetics15020010
Krittanawong C, Ang SP, Padilla FA, Qadeer YK, Wang Z, Gaibazzi N, Sharma SK, Lavie CJ, Schaff HV, Schwarz ER. Medical Therapy Versus Percutaneous Coronary Intervention in Patients with Myocardial Bridging from a National Population-Based Cohort Study: The Use of Big Data Analytics. Cardiogenetics. 2025; 15(2):10. https://doi.org/10.3390/cardiogenetics15020010
Chicago/Turabian StyleKrittanawong, Chayakrit, Song Peng Ang, Fernando Alexis Padilla, Yusuf Kamran Qadeer, Zhen Wang, Nicola Gaibazzi, Samin K. Sharma, Carl J. Lavie, Hartzell V. Schaff, and Ernst R. Schwarz. 2025. "Medical Therapy Versus Percutaneous Coronary Intervention in Patients with Myocardial Bridging from a National Population-Based Cohort Study: The Use of Big Data Analytics" Cardiogenetics 15, no. 2: 10. https://doi.org/10.3390/cardiogenetics15020010
APA StyleKrittanawong, C., Ang, S. P., Padilla, F. A., Qadeer, Y. K., Wang, Z., Gaibazzi, N., Sharma, S. K., Lavie, C. J., Schaff, H. V., & Schwarz, E. R. (2025). Medical Therapy Versus Percutaneous Coronary Intervention in Patients with Myocardial Bridging from a National Population-Based Cohort Study: The Use of Big Data Analytics. Cardiogenetics, 15(2), 10. https://doi.org/10.3390/cardiogenetics15020010