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A Comprehensive Analysis of the Impact of Acute Myocardial Infarction in Patients With Celiac Disease
James R Pellegrini1, Rezwan F Munshi1, Kristen Farraj1
1Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York.
Insights
Patients with celiac disease (CD) have lower odds of developing acute myocardial infarction (AMI). Furthermore, those with CD experienced lower mortality and fewer comorbidities following AMI, contrary to prior assumptions.
Area of Science:
- Cardiology
- Gastroenterology
- Epidemiology
Background:
- Celiac disease (CD) is a chronic inflammatory condition with potential systemic implications.
- The relationship between CD and cardiovascular events like acute myocardial infarction (AMI) requires further investigation.
Purpose of the Study:
- To investigate the impact of CD on patients experiencing AMI.
- To compare mortality, hospital stay, costs, and revascularization rates in AMI patients with and without CD.
Main Methods:
- Utilized the National Inpatient Sample (2011-2018) database.
- Identified adult patients (≥18 years) with AMI, comparing those with and without a history of CD using ICD codes.
- Analyzed primary outcomes of mortality and secondary outcomes including length of stay, hospital costs, and coronary revascularization.
Main Results:
- Among 2,287,840 AMI patients, 183,027 had CD (0.08%).
- Patients with CD and AMI showed lower adjusted odds of mortality (aOR 0.41) and coronary revascularization (aOR 0.80).
- Adults with CD had lower odds of developing AMI (aOR 0.78).
Conclusions:
- Contrary to assumptions, CD is associated with a reduced risk of AMI.
- Patients with CD experiencing AMI demonstrated better outcomes, including lower mortality and revascularization rates.
Background And Aims:
We aimed to study the impact of acute myocardial infarction (AMI) in patients with celiac disease (CD).
Methods:
We used the National Inpatient Sample 2011-2018 to identify patients aged 18 years and older with a history of CD who presented with AMI using International Classification of Disease Nineth and Tenth Revision codes. Primary outcome of interest was mortality differences in AMI patients with and without CD. Secondary outcomes were in-hospital length of stay, hospital costs, and coronary revascularization.
Results:
A total of 2,287,840 weighted patients were included in this study with a principal diagnosis of AMI. Among this population, 183,027 weighted patients had a history of CD (0.08%), and 2,286,010 weighted patients had AMI without a history of CD (99.92%). Most AMI patients with and without CD were older (69.57 ± 13.21 vs 67.08 ± 13.87 years, respectively) and white (92.55% vs 75.39%, respectively). Patients with AMI and CD were more likely to be female than patients without CD (53.76% vs 38.47%; P < .05). In our study, we found that the difference in hospital charges (adjusted mean difference $2644.7) was lower among AMI and CD; however, length of stay was higher among patients with CD (adjusted mean difference 0.36 day) although they were not statistically significant (P > .05). Both cohorts had higher number of Medicare recipients and lower number of patients who self-pay. Our study also found that smoking was more prevalent among patients with CD, 12.14%, vs patients without CD, 2.51%. Moreover, patients with CD who developed AMI had a lower adjusted odds of mortality than those without CD (adjusted odds ratio [aOR] 0.41; P < .05). Patients with CD and AMI also had lower odds of coronary revascularization (aOR 0.80; P < .05). In addition, we found that adults with CD had a lower odds of developing AMI (aOR 0.78; P < .05).
Conclusion:
CD is a chronic disease leading to chronic inflammation and various nutrition-related problems which can lead to increased morbid conditions. However, we found lower odds of AMI among patients with CD, as well as lower mortality and comorbidities related to AMI, thus contradicting previous assumptions.
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