Post-Procedure Mortality after Cardiovascular Treatment Procedures in Patients with Pneumoconiosis

Pneumoconiosis (PNC) is a major occupational disease that develops as a result of occupational exposure to dust via inhalation. In addition to its harmful effects on the respiratory system, PNC can increase vulnerability to coronary heart disease (CHD)—the leading cause of death in the United States and in the world. Currently, two types of cardiovascular intervention procedures for CHD treatment are percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The objective of this study was to investigate comparative effectiveness of the two major cardiovascular intervention procedures—PCI and CABG—in PNC patients with CHD. Data from 1094 hospitalizations of adult patients with PNC and CHD (CHD-PNC patients) and 534,120 hospi-talizations of CHD patients without PNC (CHD-nonPNC) were investigated. Adjusted odds ratios for in-hospital death in relation to the type of procedure, adjusted for patient socio-demographic and clinical characteristics and hospital characteristics, were calculated using multivariable logistic regression. Men constituted 97.8% of CHD-PNC patients and 68.6% of CHD-nonPNC patients. Within the CHD-PNC group, crude (unadjusted) in-hospital mortality after CABG and PCI did not differ significantly (1.35% vs. 2.00%, p = 0.425) and remained insignificant in the multivariable analysis, adjusted for patient and hospital characteristics (adjusted OR = 0.714, 95% CI 0.220 - 2.323, p = 0.576). But in the CHD-nonPNC group, in-hospital mortality after CABG was significantly higher than after PCI both in crude analysis (2.83% vs. 1.28%, p < 0.001) and adjusted analysis (adjusted OR = 1.637, 95% CI 1.541 - 1.738, p < 0.001). The study results indicate that CABG is as safe as PCI in male CHD-PNC patients, in terms of in-hospital mortality. Further studies investigating comparative effectiveness of cardiovascular procedures in PNC patients using more detailed data are warranted.