Acute Myocardial Infarction in setting of Influenza – An analysis of National data

Wednesday, May 22, 2019
Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)
Mandira Patel, DO , University of California at Riverside, San Bernardino, CA
Prashant Patel , University of California at Riverside, San Bernardino, CA
Amish Patel, MD , University of California at Riverside, San Bernardino, CA
Steven Deutsch , University of California at Riverside, San Bernardino, CA
Anisha Rastogi, M.D. , University of California at Riverside, San Bernardino, CA
Ashis Mukherjee, M.D., FSCAI , University of California at Riverside, San Bernardino, CA

Background:
It has been demonstrated time and again that Influenza can cause vulnerable plaque rupture and precipitate acute Myocardial infarction (MI). Hence Influenza vaccination has been given a class I recommendation in ACC/AHA guidelines. However there is lack of large scale national data exploring this relationship.

Methods:
We used HCUP’s Nationwide Inpatient Sample database from 2007 till 2014. Influenza and MI hospitalizations were identified using ICD-9 codes. Student’s t-test and chi-squared test were used for univariate analysis whereas ‘Proc Surveylogistic’ in SAS was used for multivariable analysis

Results:
On weighted analysis, 13868(0.19%) acute MI admissions also had concomitant diagnosis of Influenza during the study period. This group had more women, older patients and a higher burden of comorbidities except HTN(Table 1) compared to acute MI admissions without influenza. On univariate analysis, there was higher in-patient mortality, longer length of stay and higher hospitalization costs. Higher odds of in-patient mortality was seen in multivariate analysis (Odds ratio 1.28, 95% confidence Interval 1.14-1.44, p<0.0001) even after adjusting for age group, gender, race, obesity, DM, anemia, renal failure and COPD. However, once adjusted for heart failure there was no difference in mortality.

Conclusions:
Our exploratory analysis reveals worse hospitalization outcomes in those with influenza and MI. Whether or not a patient develops heart failure during these hospitalizations seems to be the key determining factor. Further research exploring echocardiographic parameters of LV function in such setting is warranted.

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