Javed Nismat, Jadhav Preeti, Chilimuri Sridhar, Contreras Johanna, Tamis-Holland Jacqueline, Bella Jonathan N
BronxCare Health System, Bronx, NY, USA.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Am Heart J Plus. 2024 Sep 21;46:100462. doi: 10.1016/j.ahjo.2024.100462. eCollection 2024 Oct.
Current knowledge about non-acute myocardial infarction-associated cardiogenic shock (nAMI-CS) by ethnicity is limited. This study compares clinical features and outcomes of nAMI-CS in Hispanic versus non-Hispanic patients in the U.S.
Hospitalizations with nAMI-CS from 2018 to 2020 were identified using the National Inpatient Sample (NIS) database. Patients were classified by ethnicity (Hispanic vs. non-Hispanic). Statistical analysis, including Chi-square and -tests, was conducted using STATA version 18.
Out of 8607 nAMI-CS hospitalizations, 832 (9.6 %) were Hispanic. Hispanic patients were younger (62.3 ± 15.2 vs. 66.2 ± 15.3 years) and had higher incidences of smoking (2.4 % vs. 2.1 %), coronary artery disease (45.4 % vs. 44.1 %), myocardial infarction (2.9 % vs. 1.9 %), heart failure (10.1 % vs. 9.2 %), and diabetes mellitus (18.9 % vs. 18.1 %). They had lower incidences of hypertension (32.9 % vs. 34.3 %), valve disease (1.9 % vs. 2.1 %), and cerebrovascular disease (6.5 % vs. 8.5 %, all < 0.005). Hispanic patients had slightly higher in-hospital mortality rates (18.6 % vs. 17 %, < 0.001), with an adjusted odds ratio (aOR) of 1.20 (95 % CI: 1.01-1.50, = 0.01). Their hospital stays were longer (17.7 ± 1.87 vs. 13.2 ± 0.31 days, = 0.03) and costlier ($409,280 ± 591,582 vs. $291,298 ± 461,920, = 0.03).
Hispanic nAMI-CS patients are younger, have more co-morbid conditions, longer hospital stays, higher costs, and higher in-hospital mortality rates than non-Hispanic patients. Further research is needed to understand the mechanisms behind these disparities.
目前关于不同种族非急性心肌梗死相关心源性休克（nAMI-CS）的知识有限。本研究比较了美国西班牙裔与非西班牙裔nAMI-CS患者的临床特征和结局。
使用国家住院患者样本（NIS）数据库确定2018年至2020年因nAMI-CS住院的患者。患者按种族分类（西班牙裔与非西班牙裔）。使用STATA 18版进行统计分析，包括卡方检验和t检验。
在8607例nAMI-CS住院患者中，832例（9.6%）为西班牙裔。西班牙裔患者更年轻（62.3±15.2岁对66.2±15.3岁），吸烟（2.4%对2.1%）、冠状动脉疾病（45.4%对44.1%）、心肌梗死（2.9%对1.9%）、心力衰竭（10.1%对9.2%）和糖尿病（18.9%对18.1%）的发生率更高。他们高血压（32.9%对34.3%）、瓣膜病（1.9%对2.1%）和脑血管病（6.5%对8.5%，均P<0.005）的发生率较低。西班牙裔患者的院内死亡率略高（18.6%对17%，P<0.001），调整后的优势比（aOR）为1.20（95%CI：1.01-1.50，P=0.01）。他们的住院时间更长（17.7±1.87天对13.2±0.31天，P=0.03）且费用更高（409,280美元±591,582美元对291,298美元±461,920美元，P=0.03）。
与非西班牙裔患者相比，西班牙裔nAMI-CS患者更年轻，合并症更多，住院时间更长，费用更高，院内死亡率也更高。需要进一步研究以了解这些差异背后的机制。
