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. 2023 Jul 3:10:1175731.
doi: 10.3389/fcvm.2023.1175731. eCollection 2023.

Type 2 diabetes and in-hospital sudden cardiac arrest in ST-elevation myocardial infarction in the US

Omar Mhaimeed  1   2 , Krishnadev Pillai  2 , Soha Dargham  3 , Jassim Al Suwaidi  4 , Hani Jneid  5 , Charbel Abi Khalil  2   4   6
Affiliations

Type 2 diabetes and in-hospital sudden cardiac arrest in ST-elevation myocardial infarction in the US

Omar Mhaimeed et al. Front Cardiovasc Med. .

Abstract

Aims: We aimed to assess the impact of diabetes on sudden cardiac arrest (SCA) in US patients hospitalized for ST-elevation myocardial infarction (STEMI).

Methods: We used the National Inpatient Sample (2005-2017) data to identify adult patients with STEMI. The primary outcome was in-hospital SCA. Secondary outcomes included in-hospital mortality, ventricular tachycardia (VT), ventricular fibrillation (VF), cardiogenic shock (CS), acute renal failure (ARF), and the revascularization strategy in SCA patients.

Results: SCA significantly increased from 4% in 2005 to 7.6% in 2018 in diabetes patients and from 3% in 2005 to 4.6% in 2018 in non-diabetes ones (p < 0.001 for both). Further, diabetes was associated with an increased risk of SCA [aOR = 1.432 (1.336-1.707)]. In SCA patients with diabetes, the mean age (SD) decreased from 68 (13) to 66 (11) years old, and mortality decreased from 65.7% to 49.3% during the observation period (p < 0.001). Compared to non-diabetes patients, those with T2DM had a higher adjusted risk of mortality, ARF, and CS [aOR = 1.72 (1.62-1.83), 1.52 (1.43-1.63), 1.25 (1.17-1.33); respectively] but not VF or VT. Those patients were more likely to undergo revascularization with CABG [aOR = 1.197 (1.065-1.345)] but less likely to undergo PCI [aOR = 0.708 (0.664-0.754)].

Conclusion: Diabetes is associated with an increased risk of sudden cardiac arrest in ST-elevation myocardial infarction. It is also associated with a higher mortality risk in SCA patients. However, the recent temporal mortality trend in SCA patients shows a steady decline, irrespective of diabetes.

Keywords: ST elevation myocardial infarction; cardiovascular disease; diabetes; mortality; sudden cardiac arrest.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Temporal changes of in-hospital sudden cardiac arrest in patients with diabetes (red color) and without diabetes (blue color). The X-axis represents the percentage of sudden cardiac arrest. The Y-axis represents the year.
Figure 3
Figure 3
Temporal change of in-hospital mortality in patients with sudden cardiac arrest and diabetes (red color) and without diabetes (blue). The X-axis represents the percentage of sudden mortality. The Y-axis represents the year.
See this image and copyright information in PMC

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