Abstract 11829: Cardiac Arrhythmias and Associated Mortality Risks in Alzheimer's Disease Patients Following STEMI and NSTEMI Hospitalization

Abstract

Introduction: Little is known about the outcomes of patients with Alzheimer’s disease (AD) following acute myocardial infarction (AMI). Methods: We used the 2017 National Inpatient Sample, including patients ages ≥60 with a primary diagnosis of STEMI and NSTEMI and those with any diagnostic code for AD. Any differences between AD and non-AD patients were calculated via Chi-square tests. The mortality rates of each group and their odds ratio (aOR) adjusted via multivariable logistic regression were also found. Results: A total of 104,860 cases of STEMI and 352,120 patients of NSTEMI were identified, amongst which 1,130 and 5,810 also had a diagnosis of Alzheimer’s disease. The incidence of Atrial flutter (160 cases, 1416 cases per 10,000 AD patients with STEMI), atrial fibrillation (320 cases, 2832 cases per 10,000 AD patients with STEMI), and long QT syndrome (15 cases, 133 cases per 10,000 AD patients with STEMI) for STEMI patients were higher among the AD patients (p<0.05). The incidence of ventricular fibrillation was lower among the AD group (30 cases, 265 cases per 10,000 AD patients with STEMI) compared to the non-AD group (762 cases per 10,000, p<0.01). Among the NSTEMI patients, the ventricular fibrillation rate was lower among AD patients (30 cases, 52 cases per 10,000 AD patients with NSTEMI) compared to the non-AD group (120 cases per 10,000 cases, p<0.01), and a higher number of atrial fibrillation was seen in AD patients (1755 cases, 3021 cases per 10,000 AD patients with NSTEMI) compared to non-AD patients (2589 cases per 10,000 cases, p<0.01).Finally, 25.7% of all AD cases with STEMI died (aOR 2.68, 95% CI 2.33-3.08, p<0.01), while 9.6% of AD cases with NSTEMI did not survive their hospitalization (aOR 2.28, 95% CI 2.08-2.50, p<0.01). Conclusions: Our results provide a new perspective on arrhythmias following myocardial infarction and the risk of death in patients with Alzheimer’s disease. It may be linked with A-beta amyloid 40 and 42 in the myocardium or mutations in PSEN1 and PSEN2 genes. Clinically, AD should be considered significant comorbidity during the hospitalization for AMI, and regular cardiac monitoring may be helpful to avoid any deadly outcomes.