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Am J Cardiol. 2019 Dec 27. pii: S0002-9149(19)31501-2. doi: 10.1016/j.amjcard.2019.12.032. [Epub ahead of print] In-Hospital Management and Outcomes of Patients With Acute Myocardial Infarction and Influenza.
Cardoso R1, Rivera M2, Czarny MJ3, Knijnik L2, Fernandes A2, Blumenthal RS3, Hasan RK3, Schulman SP3.
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Abstract
Patients with influenza infection are at increased risk of acute myocardial infarction (AMI). There are limited data on the short-term prognosis and management of patients with AMI and concomitant influenza. We examined the National Inpatient Sample from 2010 to 2014 for adult patients with a diagnosis of AMI. Patients were stratified into those with or without concomitant influenza. In-hospital therapies and outcomes were compared between groups in unadjusted and adjusted analyses. Standardized differences of >10% and p values <0.05 were considered significant. Propensity matching was performed using a caliper radius of 0.01*sigma. Of 4,285,641 patients with a discharge diagnosis of AMI, 12,830 had concomitant influenza. Patients with influenza were older, had a higher burden of co-morbidities, and more often presented with non-ST elevation AMI (90% vs 74%) as compared with those without influenza. Coronary angiography (23% vs 54%) and revascularization (11% vs 41%) were less often pursued in AMI patients with influenza. Patients with AMI and influenza had elevated in-hospital mortality (14%) and multiorgan failure (33%). In a propensity-matched analysis of 23,415 patients, in-hospital mortality (odds ratio [OR] 1.26; p = 0.01), acute kidney injury (OR 1.36; p <0.01), multiorgan failure (OR 1.81; p <0.01), length-of-stay, and hospital costs were significantly higher in those with influenza. In conclusion, patients with AMI and concomitant influenza have an adverse in-hospital prognosis as compared with those without influenza.
Copyright ? 2019 Elsevier Inc. All rights reserved.
PMID: 31932083 DOI: 10.1016/j.amjcard.2019.12.032