Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, Ohio.
Division of Medicine, Forrest General Hospital, Hattiesburg, Miss.
Am J Med. 2022 Aug;135(8):975-983.e2. doi: 10.1016/j.amjmed.2022.04.001. Epub 2022 Apr 22.
Types 1 and 2 myocardial infarction (MI) may occur in the setting of gastrointestinal bleeding (GIB). There is a paucity of data pertinent to the contemporary prevalence and impact of types 1 and 2 MI following GIB. We examined clinical profiles and the prognostic impact of both MI types on outcomes of patients hospitalized with GIB.
The 2018 Nationwide Readmission Database was queried for patients hospitalized for the primary diagnosis of GIB and had concomitant diagnoses of type 1 or type 2 MI. Baseline characteristics, in-hospital mortality, resource utilization, and 30-day all-cause readmissions were compared among groups.
Of 381,867 primary GIB hospitalizations, 2902 (0.75%) had type 1 MI and 3963 (1.0%) had type 2 MI. GIB patients with type 1 and type 2 MI had significantly higher in-hospital mortality compared to their counterparts without MI (adjusted odds ratios [aOR]: 4.72, 95% confidence interval [CI] 3.43-6.48; and aOR: 2.17, 95% CI 1.48-3.16, respectively). Both types 1 and 2 MI were associated with higher rates of discharge to a nursing facility (aOR of type 1 vs. no MI: 1.65, 95% CI 1.45-1.89, and aOR of type 2 vs no MI: 1.37, 95% CI 1.22-1.54), longer length of stay, higher hospital costs, and more 30-day all-cause readmissions (aOR of type 1 vs no MI: 1.22, 95% CI 1.08-1.38; aOR of type 2 vs no MI: 1.17, 95% CI 1.05-1.30).
Types 1 and 2 MI are associated with higher in-hospital mortality and resource utilization among patients hospitalized with GIB in the United States.
1 型和 2 型心肌梗死（MI）可能发生在胃肠道出血（GIB）的情况下。关于 GIB 后 1 型和 2 型 MI 的当代患病率和影响的数据很少。我们研究了临床特征以及这两种 MI 类型对 GIB 住院患者结局的预后影响。
我们查询了 2018 年全国再入院数据库，纳入因 GIB 住院且伴有 1 型或 2 型 MI 诊断的患者。比较各组之间的基线特征、住院死亡率、资源利用和 30 天全因再入院率。
在 381867 例原发性 GIB 住院患者中，有 2902 例（0.75%）患有 1 型 MI，3963 例（1.0%）患有 2 型 MI。与无 MI 的患者相比，患有 1 型和 2 型 MI 的 GIB 患者的住院死亡率显著更高（调整后比值比 [aOR]：4.72，95%置信区间 [CI] 3.43-6.48；aOR：2.17，95% CI 1.48-3.16）。1 型和 2 型 MI 均与更高的疗养院出院率相关（1 型 vs. 无 MI 的 aOR：1.65，95% CI 1.45-1.89，2 型 vs. 无 MI 的 aOR：1.37，95% CI 1.22-1.54）、更长的住院时间、更高的住院费用和更多的 30 天全因再入院率（1 型 vs. 无 MI 的 aOR：1.22，95% CI 1.08-1.38；2 型 vs. 无 MI 的 aOR：1.17，95% CI 1.05-1.30）。
在美国，1 型和 2 型 MI 与 GIB 住院患者的住院死亡率和资源利用增加相关。
