A nationwide trend analysis on the usage of endomyocardial biopsy

Abstract

AbstractBackgroundEndomyocardial biopsy (EMB) is a safe procedure performed in diagnostic work‐up of cardiac disease.HypothesisData regarding temporal trends of total numbers, characteristics, in‐hospital outcomes, and complications of patients undergoing EMB are sparse.MethodsThe nationwide German inpatient sample (2005–2019) was used for this analysis. Patient cases of EBM during the 5‐year cycles from 2005 to 2009, 2010 to 2014, and 2015 to 2019 were compared, and temporal trends regarding total numbers and presumable major and minor EMB‐associated complications were investigated.ResultsOverall, 67 745 EMB were performed in Germany 2005–2019. Total number of EMB increased from 3083 in 2005 to 5646 in 2019 (β 0.40 [95% confidence interval [CI] 0.37–0.43], p < .001). Among these EMB, 19 083 (28.2%) were performed during the period 2005–2009, 22 867 (33.7%) 2010–2014, and 25 795 (38.1%) between 2015 and 2019. The proportion of patients aged ≥70 years was highest 2015–2019 (2005–2009: 9.3%; 2010–2014: 13.8%; 2015–2019: 16.1%, p < .001) and the most aggravated comorbidity profile (Charlson Comorbidity Index 2.25 ± 1.93; 2.67 ± 2.14; 3.01 ± 2.29, p < .001) was also detected 2015–2019. Major complications occurred less often in the period 2015–2019 compared to 2005–2009 (odds ratio [OR] 0.921 [95% CI 0.893–0.950], p < .001), whereas minor complications were more frequently observed between 2015 and 2019 (OR 1.067 [95% CI 1.042–1.093], p < .001). While a decrease in major complications was detected irrespective of age, an increase in minor complications was identified only in patients between 30–59 years.ConclusionsAnnual numbers of EMB increased significantly in Germany 2005–2019. Patients who underwent EMB in recent years were older and showed an aggravated comorbidity profile accompanied by fewer major complications, underscoring safety of the procedure.