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ST-elevation myocardial infarction among cardiac amyloidosis patients; a national readmission database study

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Abstract

Literature regarding recent trends, mortality outcomes of ST-elevation myocardial infarction (STEMI) in cardiac amyloidosis (CA) patients is limited.

To study coronary interventions, and trends in prevalence and mortality outcomes among CA patients with STEMI.

Data from the national readmissions database (NRD) sample that constitutes 49.1% of the stratified sample of all hospitals in the USA, representing more than 95% of the national population, were analyzed for hospitalizations associated with CA with STEMI. A linear p-trend was used to assess the trends.

Out of the total 4252 adult patients (mean age 73.3 ± 11.7 years, 40.2% females) with diagnosis of CA, 439 (10.3%) had STEMI while 3813 (89.7%) had no STEMI. STEMI-CA patients had higher rates of multi-organ manifestations including VT/VF (12% vs 8.5%; p-value < 0.001), cardiogenic shock (12.7% vs 7.3%; p < 0.001), AKI requiring dialysis (5.3% vs 4%; p < 0.001), and ICU admissions (25.2% vs 15.3%; p < 0.001) compared to CA without STEMI. CA-STEMI had increased mortality rates (23.7% vs 16.1%, p < 0.001) compared to CA without STEMI. On multivariate logistic regression analysis, coronary interventions including PCI (OR 0.6, CI 0.4–1.1; p = 0.3) and CABG (OR 0.7, CI 0.3–1.8; p = 0.2) had no association with mortality among CA patients. The absolute yearly trends for prevalence and mortality associated with STEMI in CA patients remained steady over the study years (linear p-trends 0.2 and 0.6, respectively).

CA-STEMI is associated with significant complications and mortality. Coronary interventions may not have significant mortality benefits. Thus, more research will be needed to improve mortality rates among these patients.

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Authors and Affiliations

  1. Internal Medicine, Detroit Medical Center, Wayne State University, St Antoine Street, Detroit, MI, 420148201, USA

    Mohammed M. Uddin, Tanveer Mir & Eskara Pervaiz

  2. Internal Medicine, Saint Joseph Mercy Oakland, Pontiac, MI, USA

    Jasmeet Kaur

  3. Division of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA

    Mohammed Amir Babu

  4. Division of Cardiovascular Disease, ProMedica Physicians Cardiology, Toledo, OH, USA

    Mujeeb Sheikh

Authors
  1. Mohammed M. Uddin
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  2. Tanveer Mir
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  3. Jasmeet Kaur
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  4. Eskara Pervaiz
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  5. Mohammed Amir Babu
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  6. Mujeeb Sheikh
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Correspondence to Mohammed M. Uddin.

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Ethics approval and consent to participate

The study was exempt from institutional review board evaluation as it is based on a public database; however, it was performed according to the ethical criteria set up by Healthcare Cost and Utilization Project (HCUP). All authors have participated in the work and have reviewed and agree with the content of the article.

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Uddin, M.M., Mir, T., Kaur, J. et al. ST-elevation myocardial infarction among cardiac amyloidosis patients; a national readmission database study. Heart Fail Rev 27, 1579–1586 (2022). https://doi.org/10.1007/s10741-021-10210-w

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  • DOI: https://doi.org/10.1007/s10741-021-10210-w

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