1198 Temporal Trends of Acute Myocardial Infarction-Related Hospitalizations in Celiac Disease Patients

Abstract

INTRODUCTION: Celiac disease (CD) is a chronic autoimmune inflammatory disease of small bowel. There is availability of mixed data about influence of CD on the incidence of Acute Myocardial Infarction (AMI). Some studies have suggested that patients with CD have a worse atherosclerotic profile due to the underlying inflammatory state and restriction of whole grains in their diet. We aimed to evaluate temporal trends of incidence and mortality of CD + AMI hospitalizations in the largest nationally representative sample. METHODS: We reviewed Nationwide Inpatient Sample from 2005-2014 for adult AMI hospitalizations (includes ST elevation and Non ST elevation MI) as a principal diagnosis with CD as the secondary diagnosis by using validated ICD9-CM codes. We examined the annual trends in the number of cases and hospitalization charges yearly and used survey regression to calculate adjusted odds ratios (aOR) for hospital mortality and other outcomes. RESULTS: We identified a total of 61,80,485 AMI hospitalizations from 2005-2014 of which 3169 had a diagnosis for CD. The proportion of patients with CD in AMI hospitalizations increased from 0.015% in 2005 to % 0.076% in 2014 (Figure 1). CD + AMI hospitalizations were significant (P < 0.02) for being older (70.3 vs. 67.4 years), more female (51.9% vs. 39.5%); higher proportion of whites (93.8% vs. 76.6%; P < 0.01) and more prevalent in the Northeast (28.7% vs 19.5%) and West (21.0% vs 17.5%) United States. After adjusting for age, gender, race, Charlson Comorbidity index and hospital level characteristics, CD + AMI hospitalizations had lower odds-ratio for hospital mortality (aOR = 0.39; 95% CI = 0.23-0.67; P < 0.01). Length of stay in the CD + AMI patients was shorter (4.53 vs 4.84 days, P < 0.01) but the mean hospitalization charges was higher ($64058 vs $60223, P < 0.01), as compared to non-CD AMI patients. CONCLUSION: The results of our study provide valuable epidemiological data about the occurrence of AMI in CD patients. We found that the number of AMIs in the CD patients has risen more than five-fold from 2005-2014. However, the odds of in-hospital mortality in these patients is lower than the patients without CD for unknown reasons. The results of our study add to the current literature that though the CD-related systemic inflammation is associated with an increasing number of AMI hospitalization but these patients have comparably favorable outcomes than controls.