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Outcomes of Patients With Type 2 Myocardial Infarction Complicating Acute Ischemic Stroke

      Abstract

      Objective

      To study the patient profiles and the prognostic impact of type 2 myocardial infarction (MI) on outcomes of acute ischemic stroke (AIS).

      Methods

      The National Readmission Database 2018 was queried for patients with primary AIS hospitalizations with and without type 2 MI. Baseline characteristics, inpatient outcomes, and 30-day all-cause readmissions between cohorts were compared.

      Results

      Of 587,550 AIS hospitalizations included in the study, 4182 (0.71%) had type 2 MI. Patients with type 2 MI were older (73.6 years vs 70.1 years; P<.001) and more likely to be female (52% vs 49.7%; P<.001), and they had a higher prevalence of heart failure (32.6% vs 15.5%; P<.001), atrial fibrillation (38.5% vs 24.2%; P<.001), prior MI (8.8% vs 7.7%; P<.001), valvular heart disease (17% vs 9.8%; P<.001), peripheral vascular disease (12.2% vs 9.2%; P<.001), and chronic kidney disease (24.4% vs 16.7%; P<.001). Compared with patients without type 2 MI, AIS patients with type 2 MI had significantly higher in-hospital mortality (adjusted odds ratio [aOR], 1.96; 95% CI, 1.65 to 2.32), poor functional outcome (aOR, 1.80; 95% CI, 1.62 to 2.00), more hospital costs (adjusted parameter estimate, $5618; 95% CI, $4480 to $6755), higher rate of discharge to a facility (aOR, 1.70; 95% CI, 1.52 to 1.90), increased length of stay (adjusted parameter estimate, 2.22; 95% CI, 1.72 to 2.72), and higher rate of 30-day all-cause readmissions (aOR, 1.38; 95% CI, 1.18 to 1.60).

      Conclusion

      Type 2 MI in patients hospitalized with AIS is associated with poor prognosis and higher resource utilization.

      Abbreviations and Acronyms:

      AF (atrial fibrillation), AHRQ (Agency for Health Care Research and Quality), AIS (acute ischemic stroke), CKD (chronic kidney disease), HCUP (Healthcare Cost and Utilization Project), HF (heart failure), ICD-10-CM (International Classification of Diseases), Tenth Revision (Clinical Modification), LOS (length of stay), MI (myocardial infarction), MT (mechanical thrombectomy), NRD (Nationwide Readmission Database), OR (odds ratio)
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