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2024 ; 16
(7
): 412-421
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Impact of depression on in-hospital outcomes for adults with type 2 myocardial
infarction: A United States population-based analysis
#MMPMID39086894
Neppala S
; Chigurupati HD
; Chauhan S
; Chinthapalli MT
; Desai R
World J Cardiol
2024[Jul]; 16
(7
): 412-421
PMID39086894
show ga
BACKGROUND: Type 2 myocardial infarction (T2MI) is an ischemic myocardial injury
in the context of oxygen supply/demand mismatch in the absence of a primary
coronary event. However, though there is a rising prevalence of depression and
its potential association with type 1 myocardial infarction (T1MI), data remains
non-existent to evaluate the association with T2MI. AIM: To identify the
prevalence and risk of T2MI in adults with depression and its impact on the
in-hospital outcomes. METHODS: We queried the National Inpatient Sample (2019) to
identify T2MI hospitalizations using Internal Classification of Diseases-10 codes
in hospitalized adults (? 18 years). In addition, we compared sociodemographic
and comorbidities in the T2MI cohort with vs without comorbid depression.
Finally, we used multivariate regression analysis to study the odds of T2MI
hospitalizations with vs without depression and in-hospital outcomes (all-cause
mortality, cardiogenic shock, cardiac arrest, and stroke), adjusting for
confounders. Statistical significance was achieved with a P value of < 0.05.
RESULTS: There were 331145 adult T2MI hospitalizations after excluding T1MI
(median age: 73 years, 52.8% male, 69.9% white); 41405 (12.5%) had depression,
the remainder; 289740 did not have depression. Multivariate analysis revealed
lower odds of T2MI in patients with depression vs without [adjusted odds ratio
(aOR) = 0.88, 95% confidence interval (CI): 0.86-0.90, P = 0.001]. There was the
equal prevalence of prior MI with any revascularization and a similar prevalence
of peripheral vascular disease in the cohorts with depression vs without
depression. There is a greater prevalence of stroke in patients with depression
(10.1%) vs those without (8.6%). There was a slightly higher prevalence of
hyperlipidemia in patients with depression vs without depression (56.5% vs
48.9%), as well as obesity (21.3% vs 17.9%). There was generally equal prevalence
of hypertension and type 2 diabetes mellitus in both cohorts. There was no
significant difference in elective and non-elective admissions frequency between
cohorts. Patients with depression vs without depression also showed a lower risk
of all-cause mortality (aOR = 0.75, 95%CI: 0.67-0.83, P = 0.001), cardiogenic
shock (aOR = 0.65, 95%CI: 0.56-0.76, P = 0.001), cardiac arrest (aOR = 0.77,
95%CI: 0.67-0.89, P = 0.001) as well as stroke (aOR = 0.79, 95%CI: 0.70-0.89, P =
0.001). CONCLUSION: This study revealed a significantly lower risk of T2MI in
patients with depression compared to patients without depression by decreasing
adverse in-hospital outcomes such as all-cause mortality, cardiogenic shock,
cardiac arrest, and stroke in patients with depression.