There are limited contemporary data on the management and outcomes of acute myocardial
infarction (AMI) in patients with concomitant acute respiratory infections. Hence,
using the National Inpatient Sample from 2000-2017, adult AMI admissions with and
without concomitant respiratory infections were identified. We evaluated in-hospital
mortality, utilization of cardiac procedures, hospital length of stay, hospitalization
costs, and discharge disposition. Among 10,880,856 AMI admissions, respiratory infections
were identified in 745,536 (6.9%). Temporal trends revealed a relatively stable tr
end with a peak during 2008-2009. Admissions with respiratory infections were on average
older (74 vs. 67 years), female (45% vs 39%), with greater comorbidity (mean Charlson
comorbidity index 5.9 ± 2.2 vs 4.4 ± 2.3), and had higher rates of non-ST-segment-elevation
AMI presentation (71.8% vs. 62.2%) (all p < 0.001). Higher rates of cardiac arrest
(8.2% vs 4.8%), cardiogenic shock (10.7% vs 4.4%), and acute organ failure (27.8%
vs 8.1%) were seen in AMI admissions with respiratory infections. Coronary angiography
(41.4% vs 65.6%, p < 0.001) and percutaneous coronary intervention (20.7% vs 43.5%,
p < 0.001) were used less commonly in those with respiratory infections. Admissions
with respiratory infections had higher in-hospital mortality (14.5% vs 5.5%; propensity
matched analysis: 14.6% vs 12.5%; adjusted odds ratio 1.25 [95% confidence interval
1.24-1.26], p < 0.001), longer hospital stay, higher hospitalization costs, and less
frequent discharges to home compared to those without respiratory infections. In conclusion,
respiratory infections significantly impact AMI admissions with higher rates of complications,
mortality and resource utilization.
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References
- Primary and secondary prevention of cardiovascular disease in the era of the coronavirus pandemic.Circulation. 2020; 141: 1943-1945
- Cardiovascular health in the COVID-19 era: a call for action and education.Mayo Clin Proc. 2020; 95: 1584-1588
- Acute myocardial infarction treatments and outcomes in 6.5 million patients with a current or historical diagnosis of cancer in the USA.Eur Heart J. 2020; 41: 2183-2193
- High thrombus burden in patients with COVID-19 presenting with ST-segment elevation myocardial infarction.J Am Coll Cardiol. 2020; 76: 1168-1176
- Microthrombi and ST-segment-elevation myocardial infarction in COVID-19.Circulation. 2020; 142: 804-809
- Acute infection and myocardial infarction.N Engl J Med. 2019; 380: 171-176
- The association between pneumococcal pneumonia and acute cardiac events.Clin Infect Dis. 2007; 45: 158-165
- Acute myocardial infarction after laboratory-confirmed influenza infection.N Engl J Med. 2018; 378: 345-353
- Seasonal influenza infections and cardiovascular disease mortality.JAMA Cardiol. 2016; 1: 274-281
- In-hospital management and outcomes of patients with acute myocardial infarction and influenza.Am J Cardiol. 2020; 125: 840-844
- Outcomes of acute myocardial infarction in patients with influenza and other viral respiratory infections.Am J Med. 2019; 132: 1173-1181
- Cardiovascular complications and short-term mortality risk in community-acquired pneumonia.Clin Infect Dis. 2017; 64: 1486-1493
- Introduction to HCUP National Inpatient Sample (NIS).2012
- Acute myocardial infarction-cardiogenic shock in patients with prior coronary artery bypass grafting: A 16-year national cohort analysis of temporal trends, management and outcomes.Int J Cardiol. 2020; 310: 9-15
- Acute noncardiac organ failure in acute myocardial infarction with cardiogenic shock.J Am Coll Cardiol. 2019; 73: 1781-1791
- Regional variation in the management and outcomes of acute myocardial infarction with cardiogenic shock in the United States.Circ Heart Fail. 2020; 13e006661
- Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.Med Care. 2005; 43: 1130-1139
- Pulmonary artery catheter use in acute myocardial infarction-cardiogenic shock.ESC Heart Fail. 2020; 7: 1234-1245
- Hospital-level disparities in the outcomes of acute myocardial infarction with cardiogenic shock.Am J Cardiol. 2019; 124: 491-498
- Temporal trends and outcomes of prolonged invasive mechanical ventilation and tracheostomy use in acute myocardial infarction with cardiogenic shock in the United States.Int J Cardiol. 2019; 285: 6-10
- Adherence to methodological standards in research using the National Inpatient Sample.JAMA. 2017; 318: 2011-2018
- Acute pneumonia and the cardiovascular system.Lancet. 2013; 381: 496-505
- Temporal trends in acute myocardial infarction presentation and association with use of cardioprotective drugs: a nationwide registry-based study.Eur Heart J Cardiovasc Pharmacother. 2018; 4: 93-101
- Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006.Am Heart J. 2008; 156: 1026-1034
- Bacterial complications of respiratory tract viral illness: a comprehensive evaluation.J Infect Dis. 2013; 208: 432-441
- Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.Chest. 2011; 139: 555-562
- Influence of seasons on the management and outcomes acute myocardial infarction: an 18-year united states study.Clin Cardiol. 2020; 43: 1175-1185
Article info
Publication history
Published online: May 15, 2021
Received in revised form:
March 10,
2021
Received:
December 31,
2020
Footnotes
Disclosures: All authors have reported that they have no relevant disclosures.
Sources of Funding: None.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
