OR06-6
IN-HOSPITAL OUTCOMES OF POST-MYOCARDIAL INFARCTION COMPLICATIONS IN PATIENTS WITHOUT STANDARD MODIFIABLE RISK FACTORS: A NATIONWIDE ANALYSIS
Presenter
James Choi, MBBS BSc (Hons), Icahn School of Medicine at Mount Sinai, New York, NY
James Choi, MBBS BSc (Hons)1, Sara Diaz, MD1, Christopher N Matthews, DO, MBA2, Matthew Baer, MD1, Andrew Cole, MBBS3, Kiran Mahmood, MD4 and Nitin Barman, M.D., FSCAI5, (1)Icahn School of Medicine at Mount Sinai, New York, NY, (2)Icahn School of Medicine at Mount Sinai Morningside, New York, NY, (3)King’s College Hospital NHS Foundation Trust, London, London, United Kingdom, (4)Icahn School of Medicine at Mount Sinai Morningside, New york, NY, (5)Mount Sinai Morningside, New York, NY
Keywords: Acute Coronary Syndromes (ACS), Complications and Coronary
Background
Recent studies show that patients without standard modifiable risk factors (SMuRF-less) have poorer outcomes in acute myocardial infarction (AMI). This study explores the risk of post-myocardial infarction complications in this subset of patients, which has not yet been studied.
Methods
This is a retrospective study using the National Inpatient Sample for hospitalizations between 2017 - 2019. ICD-10 codes identified patients presenting with AMI divided into those with and without SMuRFs (diabetes mellitus, hyperlipidemia, hypertension, and smoking). The outcomes of interest were mortality and post-AMI complications. Multivariate logistic analysis was used to adjust for age, gender, race, location, and relevant co-morbidities with a p-value <0.2 in univariate screen.
Results
3,476,360 patients were hospitalized with AMI, of which 11.7% were SMuRF-less. Compared to those with one or more SMuRFs, SMuRF-less patients have increased adjusted odds of mortality (OR 2.65, 95% CI 2.58 - 2.72) and post-AMI complications including hemopericardium (OR 2.90, 95% CI 1.79 - 4.79), wall rupture (OR 2.52, 95% CI 1.69 - 3.77), cardiogenic shock (OR 1.84, 95% CI 1.78 - 1.89) and cardiac arrest (OR 1.95, 95% CI 1.89 - 2.02).
Conclusions
We observed a substantial increase in the likelihood of post-AMI complications in SMuRF-less patients. This further underscores the need to recognize non-conventional risk factors in coronary artery disease. Future studies may help to clarify these associations.
