Quivering hand and heart: Parkinson's disease is not associated with increased in-hospital mortality in atrial fibrillation hospitalizations: A nationwide analysis
Emmanuel Ukenenye,
Tolulope Oshiba,
Emeka Okoronkwo,
Elvis Obomanu,
Gideon Asaolu,
Alexsandra Urhi,
Iyanu Victoria Olateju,
Henry Onyemarim,
Consolata Uzzi,
Gabriel Alugba,
Adeolu Funso Oladunjoye,
Olubunmi Oladunjoye
Affiliations
Emmanuel Ukenenye
One Brooklyn Health-Brookdale University Hospital and Medical Center Medical, Brooklyn, NY, United States; Medical Council of Jamaica, University of the West Indies, 18 West Rd, Kingston, 2762+3VM, Jamaica; Corresponding author. One Brooklyn Health-Brookdale University Hospital and Medical Center Medical, Brooklyn, NY, United States
Tolulope Oshiba
Hospitalist/Emergency Medicine Department, University of Texas Health Science Center/UT Physicians/Memorial Hermann Hospital, 6410 Fannin St, Houston, TX 77030, United States
Emeka Okoronkwo
Neurology Unit of Department of Medicine, Lagos University Teaching Hospital, Ishaga Rd, Idi-Araba, Lagos 102215, Nigeria
Elvis Obomanu
Department of Project Management, Translational Research in Oncology, 9925 109 St NW Suite 1100, Edmonton, AB T5K 2J8, Alberta, Canada
Background: Autonomic dysfunction in Parkinson's disease (PD) includes cardiovascular dysregulations which may manifest as an increased risk of atrial fibrillation (AF). However, data on the impact of PD in AF patients is lacking. Our study aimed to investigate the differences in in-hospital mortality of patients admitted for AF with underlying PD versus those without PD. Methods: We examined the National Inpatient Sample (NIS) database from 2016 to 2019 for hospitalizations of AF as a principal diagnosis with and without PD as a secondary diagnosis. The primary outcome was inpatient mortality. The secondary endpoints were ventricular tachycardia (VT), ventricular fibrillation (VF), acute heart failure (AHF), cardiogenic shock (CS), cardiac arrest (CA), total hospital charge (THC), and length of stay (LOS). Results: Of 1,861,859 A F hospitalizations, 0.01% (19,490) had coexisting PD. Cohorts of PD vs No-PD had a mean age of 78.1 years [CI 77.9–78.4] vs 70.5 years [CI 70.4–70.5]; male (56.3% vs 50.7%), female (43.7% vs 49.3%). The PD category had similar in-hospital mortality with the no-PD category (ORAdj = 1.18 [0.89–1.57] P = 0.240). The PD group had a lesser incidence of AHF (ORAdj = 0.79 [0.72–0.86] P < 0.001) and VT (ORAdj = 0.77 [0.62–0.95] P = 0.015). Conclusion: Co-existing PD in patients admitted for AF was not associated with increased in-hospital mortality; however, there were lower odds of AHF and VT. The diminished arrhythmogenic neurohormonal axis may explain these cardiovascular benefits. Notwithstanding, to better understand the outcomes of AF in patients with PD, additional studies are required.
