Publication Date
11-1-2021
Journal
The American Journal of Medicine
DOI
10.1016/j.amjmed.2021.05.022
PMID
34214459
PMCID
PMC9131468
PubMedCentral® Posted Date
5-25-2022
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Aged, Anemia, Case-Control Studies, Comorbidity, Female, Heart Failure, Hospital Costs, Hospital Mortality, Hospitalization, Humans, Hypertension, Length of Stay, Male, Myocardial Infarction, Nervous System Diseases, Nursing Homes, Patient Discharge, Patient Readmission, Prevalence, Renal Insufficiency, Chronic, Sex Factors, United States, Weight Loss
Abstract
BACKGROUND: Type 2 myocardial infarction (MI) is increasingly diagnosed in patients with heart failure (HF). A paucity of data exists pertinent to the contemporary prevalence and impact of type 2 MI in patients with HF. We studied the patient profiles and the prognostic impact of type 2 MI on outcomes of HF hospitalizations.
METHODS: The Nationwide Readmission Database 2018 was queried for patients with HF hospitalizations with and without type 2 MI. Baseline characteristics, inpatient outcomes, and 30-day all-cause readmissions between both cohorts were compared.
RESULTS: Of 1,072,674 primary HF hospitalizations included in the study, 28,813 (2.7%) had type 2 MI. Patients with type 2 MI were more likely to be males (56.5% vs 51.6%; P < .001) and had a higher prevalence of hypertension (94% vs 92.2%; P < .001), prior myocardial infarction (17.1% vs 14.9%; P < .001), anemia (9.1% vs 8.1%; P < .001), chronic kidney disease (55.7% vs 49.4%; P < .001), neurological disorders (9.4% vs 7.3%; P < .001), and weight loss (7.3% vs 5.6%; P < .001). Compared with their counterparts without type 2 MI, patients with HF with type 2 MI had significantly higher in-hospital mortality (adjusted odds ratio [aOR], 1.53; 95% confidence interval [CI], 1.37-1.72), hospital costs (adjusted parameter estimate, $1785; 95% CI, 1388-2182), discharge to nursing facility (aOR, 1.22; 95% CI, 1.15-1.29), longer length of stay (adjusted parameter estimate, 0.53; 95% CI, 0.42-0.64), and rate of 30-day all-cause readmissions (aOR, 1.06; 95% CI, 1.01-1.12).
CONCLUSION: Type 2 MI in patients hospitalized with HF is associated with higher mortality and resource utilization in the United States.
Included in
Biochemistry, Biophysics, and Structural Biology Commons, Cardiology Commons, Cardiovascular Diseases Commons, Critical Care Commons, Medical Sciences Commons
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