AUTHOR=Mhaimeed Omar , Pillai Krishnadev , Dargham Soha , Al Suwaidi Jassim , Jneid Hani , Abi Khalil Charbel 

TITLE=Type 2 diabetes and in-hospital sudden cardiac arrest in ST-elevation myocardial infarction in the US

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1175731

DOI=10.3389/fcvm.2023.1175731

ISSN=2297-055X

ABSTRACT=Aims: We aimed to assess the impact of diabetes on sudden cardiac arrest (SCA) in US patients hospitalized for ST-elevation myocardial infarction (STEMI).

Methods:  We used the National Inpatient Sample (2005-2017) data to identify adult patients with STEMI. The primary outcome was in-hospital SCA. Secondary outcomes included in-hospital mortality, ventricular tachycardia (VT), ventricular fibrillation (VF), cardiogenic shock (CS), acute renal failure (ARF), and the revascularization strategy in SCA patients.

Results:  SCA significantly increased from 4% in 2005 to 7.6% in 2018 in diabetes patients and from 3% in 2005 to 4.6% in 2018 in non-diabetes ones (p<0.001 for both). Further, diabetes was associated with an increased risk of SCA (aOR = 1.432 [1.336 – 1.707]).  In SCA patients with diabetes, the mean age (SD) decreased from 68 (13) to 66 (11) years old, and mortality decreased from 65.7% to 49.3% during the observation period (p<0.001). Compared to non-diabetes patients, those with T2DM had a higher adjusted risk of mortality, ARF, and CS (aOR = 1.72 [1.62–1.83], 1.52 [1.43–1.63], 1.25 [1.17–1.33]; respectively) but not VF or VT. Those patients were more likely to undergo revascularization with CABG [aOR = 1.197 (1.065-1.345)] but less likely to undergo PCI [aOR = 0.708 (0.664-0.754)].

Conclusion:  Diabetes is associated with an increased risk of sudden cardiac arrest in ST-elevation myocardial infarction. It is also associated with a higher mortality risk in SCA patients. However, the recent temporal mortality trend in SCA patients shows a steady decline, irrespective of diabetes.