Korean Circ J.  2023 Dec;53(12):829-839. 10.4070/kcj.2023.0063.

Trends and Outcomes of Type 2 Myocardial Infarction During the COVID-19 Pandemic in the United States

• Thyagaturu H
• Roma N
• Angirekula A
• Thangjui S
• Bolton A
• Gonuguntla K
• Sattar Y
• Chobufo MD
• Challa A
• Patel N
• Bondi G
• Raina S

• KMID: 2548790
• DOI: http://doi.org/10.4070/kcj.2023.0063

Abstract

Background and Objectives
There is limited data on the impact of type 2 myocardial infarction (T2MI) during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
The National Inpatient Sample (NIS) database from January 2019 to December 2020 was queried to identify T2MI hospitalizations based on the appropriate International Classification of Disease, Tenth Revision-Clinical Modification codes. Monthly trends of COVID-19 and T2MI hospitalizations were evaluated using Joinpoint regression analysis. In addition, the multivariate logistic and linear regression analysis was used to compare inhospital mortality, coronary angiography use, and resource utilization between 2019 and 2020.
Results
A total of 743,535 patients hospitalized with a diagnosis of T2MI were identified in the years 2019 (n=331,180) and 2020 (n=412,355). There was an increasing trend in T2MI hospitalizations throughout the study period corresponding to the increase in COVID-19 hospitalizations in 2020. The adjusted odds of in-hospital mortality associated with T2MI hospitalizations were significantly higher in 2020 compared with 2019 (11.1% vs. 8.1%: adjusted odds ratio, 1.19 [1.13–1.26]; p<0.01). In addition, T2MI hospitalizations were associated with lower odds of coronary angiography and higher total hospitalization charges,with no difference in the length of stay in 2020 compared with 2019.
Conclusions
We found a significant increase in T2MI hospitalizations with higher inhospital mortality, total hospitalization costs, and lower coronary angiography use during the early COVID-19 pandemic corresponding to the trends in the rise of COVID-19 hospitalizations. Further research into the factors associated with increased mortality can increase our preparedness for future pandemics.

Keyword

COVID-19; SARS-CoV-2; Myocardial infarction; Myocardial ischemia

Figure

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  Figure 1 Various trends in COVID-19 hospitalizations and T2MI.(A) Trends in COVID-19 hospitalizations in the year 2020. The trend of COVID-19 patient hospitalizations across 2020 by month with a p-trend <0.01. (B) Trends of T2MI hospitalizations in the background of COVID-19 hospitalizations. The patients admitted to the hospital with T2MI in 2019 and 2020 were displayed with COVID-19 hospitalizations in 2020. (C) Trends of in-hospital T2MI mortality rate in the background of COVID-19 hospitalizations. The trends in the mortality rate for patients admitted to the hospital with T2MI in 2019 and 2020 were displayed with the COVID-19 hospitalizations in 2020. The overall p-trend was <0.01. (D) Trends in coronary angiography use in T2MI patients in 2019 and 2020. The trends in the use of coronary angiography in patients admitted to the hospital with T2MI in 2019 and 2020 were displayed with the COVID-19 hospitalizations in 2020. The p-trend was <0.01.COVID-19 = coronavirus disease 2019; T2MI = type 2 myocardial infarction.

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