435-P: Sex Differences in Diabetic Cardiovascular Outcomes amongst Patients Admitted for Pneumonia: A Study from the National Inpatient Sample (NIS)

Abstract

Background: While women have lower risks of cardiovascular disease (CVD) than men, type 2 diabetes mellitus (T2D) seems to be a stronger risk factor for major adverse cardiac events (MACE) for women. No study has evaluated sex differences in MACE for patients with T2D admitted for non-CVD diagnoses in the NIS. Pneumonia is one of the most common primary diagnoses in the inpatient setting. Methods: Patients hospitalized in 2013 for a primary diagnosis of pneumonia were identified from the NIS. MACE was defined as acute myocardial infarction (AMI) , ischemic stroke, cardiac arrest, or cardiogenic shock, and was compared by sex in patients with T2D. Multivariable logistic regression models were used to estimate odds of in-hospital MACE adjusted for demographics, cardiovascular risk factors, comorbidities, and pneumonia severity. Results: In 2013, 192,100 patients were admitted for a primary diagnosis of pneumonia, and 50,776 of these patients had T2D. Of the patients with T2D, 50.9% were female. Female patients with T2D were less likely to smoke and had fewer comorbidities than male patients with T2D (all P<0.001) . After adjustment, T2D was associated with increased risk of AMI for women (aOR 1.2; 95% CI 1.1-1.4, P=0.006) but not for men (aOR 1.1; 95% CI 1.0-1.2, P=0.2) . Amongst patients with T2D, there was a similar risk of MACE for women compared to men (aOR 0.9; 95% CI 0.8-1.1, P=0.257) . Conclusion: While T2D seems to be a stronger risk factor for AMI in female patients, male and female patients with T2D have an overall similar risk of in-hospital MACE when admitted for pneumonia. Disclosure S.Leventhal: None. G.Rubinfeld: None. J.S.Berger: Advisory Panel; Amgen Inc., Janssen Scientific Affairs, LLC. J.D.Newman: None. N.R.Smilowitz: Advisory Panel; Abbott.