Clinical outcomes of myocardial infarction with non-obstructive coronary arteries presenting with diabetic ketoacidosis: a propensity score-matched analysis

Autor: Asif Ullah, Umar Khan, Shumaila Asif, Hafiz Muhammad Shafique, Talha Sajid, Jateesh Kumar, Waheed Akhtar, Syed Muhammad Jawad Zaidi, Jahanzeb Malik, Amin Mehmoodi
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: European Journal of Medical Research, Vol 29, Iss 1, Pp 1-7 (2024)
Druh dokumentu: article
ISSN: 2047-783X
DOI: 10.1186/s40001-023-01633-2
Popis: Abstract Introduction and Objective There is a paucity of data on patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and a decompensated diabetic state, diabetic ketoacidosis (DKA). Therefore, we aimed to investigate the outcomes of patients with MINOCA presenting with or without DKA. Methods We conducted this retrospective propensity score-matched analysis from January 1, 2015, to December 4, 2022. The patients with a principal admission diagnosis of ST-Elevation MI (STEMI) and discharge labeled as MINOCA (ICD-10-CM code 121.9) with DKA were analyzed. We performed a comparative analysis for MINOCA with and without DKA before and after propensity score matching for primary and secondary endpoints. Results Three thousand five hundred sixty-three patients were analyzed, and 1150 (32.27%) presented with DKA, while 2413 (67.72%) presented as non-DKA. The DKA cohort had over two-fold mortality (5.56% vs. 1.19%; p = 0.024), reinfarction (5.82% vs. 1.45%; p = 0.021), stroke (4.43% vs. 1.36%; p = 0.035), heart failure (6.89% vs. 2.11%; p = 0.033), and cardiogenic shock (6.43% vs. 1.78%; p = 0.025) in a propensity score-matched analysis. There was an increased graded risk of MINOCA with DM (RR (95% CI): 0.50 (0.36–0.86; p = 0.023), DKA (RR (95% CI): 0.46 (0.24–0.67; p = 0.001), and other cardiovascular (CV) risk factors. Conclusion DKA complicates a portion of MINOCA and is associated with increased mortality and major adverse cardiovascular events (MACE).
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