In-Hospital Outcomes of Coronary Artery Stenting in Patients With ST-Elevation Myocardial Infarction (STEMI) and
Owen Igbinosa1, Ahmed Brgdar1, Joseph Asemota1
1Internal Medicine, Howard University Hospital, Washington, DC, USA.
Insights
Metabolic syndrome (MetS) in ST-elevation myocardial infarction (STEMI) patients undergoing stenting was linked to lower in-hospital mortality. This finding suggests MetS may offer a protective effect in this high-risk cardiac population.
Area of Science:
- Cardiology
- Metabolic Disorders
- Public Health
Background:
- Metabolic syndrome (MetS) is a growing global health concern.
- Concurrent MetS diagnosis is increasingly observed in ST-elevation myocardial infarction (STEMI) patients.
- Limited research exists on MetS's impact on STEMI treatment outcomes.
Purpose of the Study:
- To investigate the association between MetS and in-hospital mortality in STEMI patients.
- To evaluate outcomes of STEMI patients with MetS undergoing coronary stenting.
Main Methods:
- Retrospective analysis of STEMI patients (2005-2014) from the National Inpatient Sample database.
- Comparison of demographics, comorbidities, and outcomes between MetS and non-MetS groups.
- 1:1 propensity score matching for age, gender, and race.
Main Results:
- STEMI patients with MetS had higher rates of diabetes, hypertension, hyperlipidemia, chronic kidney disease, and obstructive sleep apnea.
- In-hospital mortality was significantly lower in the MetS group (2.5% vs. 7.1%, p<0.001).
- This reduced mortality remained significant after adjusting for confounders (OR 0.34, p<0.0001).
Conclusions:
- Concurrent MetS diagnosis in STEMI patients undergoing stenting is associated with decreased in-hospital mortality.
- The specific components of MetS contributing to this reduced mortality require further investigation.
- Future studies should explore the mechanisms behind this protective association.
Abstract:
Background Metabolic syndrome (MetS) has been recognized as a global health problem. Concurrent MetS diagnosis in patients with ST-elevation myocardial infarction (STEMI) is becoming increasingly common. Given the paucity of studies on the impact of MetS on treatment outcomes in STEMI patients, the purpose of this study was to evaluate in-hospital mortality in STEMI patients with a concurrent MetS diagnosis undergoing a stenting procedure to treat their underlying coronary artery disease. Method Patients with or without MetS who underwent coronary stenting following STEMI between 2005 and 2014 were identified from the National Inpatient Sample database. Patients' demographics, comorbidities, and outcomes were compared using a t-test and Pearson's Chi-square test. In addition, 1:1 propensity score matching was performed for age, gender, and race. Results Out of 1,938,097 STEMI patients, 5,817 patients with MetS underwent coronary stenting following STEMI and were matched with 5,817 patients with no Mets. MetS group had significantly higher rates of diabetes, hypertension, hyperlipidemia, chronic kidney disease, and obstructive sleep apnea than the no MetS group but lower rates of heart failure and chronic obstructive pulmonary disease. In-hospital mortality following STEMI was significantly lower in patients with MetS (2.5% vs. 7.1%, p<0.001) and remained significant after adjusting for potential confounders (odds ratio (OR) 0.34, 95% confidence interval (95% CI) 0.28-0.42, p<0.0001). Conclusion Concurrent diagnosis of MetS among patients undergoing coronary stenting is associated with a decreased in-hospital mortality risk. The impact of specific MetS components on the observed reduction in mortality remains unclear and warrants evaluation in future studies.
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