Echouffo-Tcheugui JB, et al. - Researchers enquired regarding the association between diabetes and the occurrence and prognosis of cardiogenic shock post-acute myocardial infarction among the National Inpatient Sample patients aged ≥18 years. Findings illustrated an increased risk of cardiogenic shock and worse outcomes linked with preexisting diabetes among individuals with cardiogenic shock.

Methods

• Experts identified patients aged ≥18 years and hospitalized for acute myocardial infarction during the 2012-2014 period among the National Inpatient Sample.
• A scrutiny was performed of the link between diabetes and the incidence and outcomes of cardiogenic shock complicating acute myocardial infarction via multivariable logistic and linear regression models.

Results

• Among 1,332,530 hospitalizations for acute myocardial infarction, 72,765 (5.5%) appeared to be complicated by cardiogenic shock.
• Data reported higher cardiogenic shock incidence in acute myocardial infarction patients, among those with vs without diabetes (5.8% vs 5.2%; adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.11-1.19; P < 0.001), with 42.8% (n=31,135) of patients with acute myocardial infarction and cardiogenic shock having diabetes.
• It was noted that diabetic patients exhibited a lesser tendency of undergoing revascularization (PCI or CABG) (67.1% vs 68.7%; aOR 0.88, 95% CI 0.80-0.96; P=0.003).
• A link was determined between diabetes with higher in-hospital mortality in patients with acute myocardial infarction and cardiogenic shock (37.9% vs 36.8%; aOR 1.18, 95% CI 1.09-1.28; P < 0.001).
• Among survivors, a longer hospital stay was reported in patients with diabetes (mean ± SEM: 11.6±0.16 vs 10.9±0.16 days; adjusted estimate 1.12, 95% CI 1.06-1.18; P < 0.001) along with a greater tendency of being discharged to skilled nursing home or with home health care (56.0% vs 50.5%; aOR 1.19, 95% CI 1.07-1.33; P=0.001).