Abstract
Background: Type 2 myocardial infarction (T2MI) is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary event. Chronic myocardial injury was linked to increased risk of stroke in the long term follow up. However, association between T2MI and stroke in short term follow up is unclear due to limited available data. Objective: To study the impact T2MI on 90-day readmission with ischemic stroke or transient ischemic attack (TIA) in elderly hospitalized patients. Methods: The study is a retrospective analysis of national readmission database (NRD) of year 2018 for patients ≥ 65 years. Patients were excluded if they had stroke, myocardial infarction other than T2MI or prior stroke in index admission. Patients admitted between October and December to allow 90 days follow up. International classification of disease, tenth edition (ICD 10-CM) was used to identify diagnoses. Multivariate logistic regression model was used to calculate adjusted odds ratio (aOR) and adjust for potential confounders (figure 1). Results: A total of 6,643,620 patients were admitted in 2018 that met our criteria. T2MI was present in 88,282 (1.3%) index admissions. A total of 1,549,951 patients were readmitted to the hospital within 90 days of whom 36,981 (2%) patients were diagnosed with stroke or TIA. Patients readmitted with stroke were more likely to be female (56% vs 55%, P=0.005), had complicated hypertension (46% vs 35%, P<0.001), complicated diabetes mellitus (28% vs. 20%, P<0.001), and congestive heart failure (35% vs 26%, P<0.001). T2MI was associated with increased risk of 90-day stroke readmission (aOR: 1.21, 95%CI [1.09-1.35], P<0.001). Conclusion: In our large retrospective study, T2MI was found to be an independent predictor of 90-day readmission with stroke or TIA in hospitalized elderly patients. Further studies are warranted to identify optimum strategy of risk stratification and management of such patient.
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