Cardiovascular outcomes of type 2 myocardial infarction among COVID-19 patients: a propensity matched national study

ABSTRACT

Background

Myocardial infarction Type II (T2MI) is a prevalent cause of troponin elevation secondary to a variety of conditions causing stress/demand mismatch. The impact of T2MI on outcomes in patients hospitalized with COVID-19 is not well studied.

Methods

The Nationwide Inpatient Sample database from the year 2020 was queried to identify COVID-19 patients with T2MI during the index hospitalization. Clinical Modification (ICD-10-CM) codes ‘U07.1’ and ‘I21.A1’ were used as disease identifiers for COVID-19 and T2MI respectively. Multivariate adjusted Odds ratio (aOR) and propensity score matching (PSM) was done to compare outcomes among COVID patients with and without T2MI. The primary outcome was in-hospital mortality.

Results

A total of 1,678,995 COVID-19-weighted hospitalizations were identified in the year 2020, of which 41,755 (2.48%) patients had T2MI compared to 1,637,165 (97.5%) without T2MI. Patients with T2MI had higher adjusted odds of in-hospital mortality (aOR 1.44, PSM 32.27%, 95% CI 1.34–1.54) sudden cardiac arrest (aOR 1.29, PSM 6.6%, 95% CI 1.17–1.43) and CS (aOR 2.16, PSM 2.73%, 95% CI 1.85–2.53) compared to patients without T2MI. The rate of coronary angiography (CA) in T2MI with COVID was 1.19%, with significant use of CA among patients with T2MI complicated by CS compared to those without CS (4% vs 1.1%, p < 0.001). Additionally, COVID-19 patients with T2MI had an increased prevalence of sepsis compared to COVID-19 without T2MI (48% vs 24.1%, p < 0.001).

Conclusion

COVID-19 patients with T2MI had worse cardiovascular outcomes with significantly higher in-hospital mortality, SCA, and CS compared to those without T2MI. Long-term mortality and morbidity among COVID-19 patients who had T2MI will need to be clarified in future studies.

KEYWORDS:

• COVID-19
• coronavirus
• severe acute respiratory syndrome coronavirus 2
• SARS CoV2
• type two myocardial infarction
• T2MI
• myocardial infarction

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Y Sattar, S Balla: Idealized and led the project; Y Sattar: Statistical Analysis; L Atti, DH: Data extraction; A Taha, L Atti: Tables, graphics, and visuals; V Victor, N Patel, A Taha, S Aziz: Writing of initial draft; N Patel, A Taha, Y Sattar, T Aziz, and MC Alraies: Critical Editing; K Gonuguntla, H Thyagaturu, Y Sattar, T Micho, MC Alraies, and S Balla: Final edits and proofreading; Mentored the project: SB

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2023.2200933

Additional information

Funding

This paper was not funded.