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Associations between periodontal disease and hospitalization outcomes in ST-segment elevation myocardial infarction:
Insights
Periodontal disease (PD) is linked to increased cardiovascular morbidity, but its impact on outcomes in ST-segment elevation myocardial infarction (STEMI) remains understudied. The authors investigated the effect of PD on STEMI outcomes.
Area of Science:
- Cardiology
- Periodontology
- Public Health
Background:
- Periodontal disease (PD) is associated with increased cardiovascular morbidity.
- The impact of PD on ST-segment elevation myocardial infarction (STEMI) outcomes is not well-established.
- This study investigates the association between PD and STEMI patient outcomes.
Purpose of the Study:
- To determine the effect of periodontal disease on outcomes in patients hospitalized with ST-segment elevation myocardial infarction.
- To analyze the association between PD and adverse events, resource utilization, and mortality in STEMI patients.
Main Methods:
- Analysis of STEMI hospitalizations from the 2016-2019 National Inpatient Sample database.
- Comparison of outcomes between STEMI patients with and without periodontal disease.
- Multivariable regression analysis adjusted for confounding factors.
Main Results:
- Patients with PD had higher odds of requiring mechanical circulatory support, mechanical ventilation, and developing cardiogenic shock and acute kidney injury.
- STEMI hospitalizations with PD were associated with longer hospital stays and higher total hospital costs.
- Mortality and vasopressor use were not significantly different between groups.
Conclusions:
- Concomitant periodontal disease in STEMI patients is associated with increased nonfatal adverse events and healthcare resource utilization.
- Recognizing PD as a comorbidity in STEMI can inform tailored care strategies and improve resource allocation.
- Further research is needed to refine risk stratification for STEMI patients with PD.
Background:
Periodontal disease (PD) is linked to increased cardiovascular morbidity, but its impact on outcomes in ST-segment elevation myocardial infarction (STEMI) remains understudied. The authors investigated the effect of PD on STEMI outcomes.
Methods:
The authors analyzed STEMI hospitalizations from the 2016-2019 National Inpatient Sample data set, comparing outcomes in patients with and without PD. Primary and secondary outcomes included mortality, mechanical circulatory support, mechanical ventilation, vasopressor use, cardiogenic shock, acute kidney injury, hospital length of stay, and total hospital cost. Multivariable regression adjusted for confounding factors.
Results:
Of 2,595,584 STEMI hospitalizations, 0.2% involved patients with an InternationalClassification of Diseases, Tenth Revision, Clinical Modification code for PD. A PD code was associated with higher odds of mechanical circulatory support use (adjusted OR [aOR], 1.57; 95% CI, 1.25 to 1.97), mechanical ventilation (aOR, 1.26; 95% CI, 1.01 to 1.58), cardiogenic shock (aOR, 1.48; 95% CI, 1.20 to 1.83), acute kidney injury (aOR, 1.32; 95% CI, 1.13 to 1.55), longer hospital stays (7.18 vs 4.40 days; P < .001), and higher hospital costs ($141,245 vs $98,152; P < .001). Mortality and vasopressor use were unchanged.
Conclusions:
Among STEMI cases, a concomitant PD code was associated with higher odds of nonfatal adverse events and health care resource use.
Practical Implications:
Recognizing PD as a comorbidity in STEMI may help tailor care strategies, reduce adverse outcomes, and improve resource allocation in clinical practice. Further studies could refine risk-stratification approaches.
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