Diabetes Mellitus and Peripartum Cardiomyopathy: A Nationwide Study

Abstract

BackgroundThe relationship between diabetes mellitus-(DM) and peripartum-cardiomyopathy(PPCM) remains uncertain. This study aims to clarify the connection between DM and PPCM to predict cardiovascular-outcomes using data from the National Readmission Database(NRD). Methods and ResultsWe analyzed data from 2016-2020 and identified 20,865 hospitalizations for PPCM, with 10.02% (2,091 cases) of them diagnosed with DM. PPCM patients with DM had a higher mean age (36 years,SD-7.6 vs 32 years,SD-6.7;p=0.000). Baseline-comorbidities were shown in Figure1. DM in PPCM has been identified as a predictor for acute-kidney-injury(AKI)[OR 2.38,95%CI 2.01-2.82,p=0.000], and major-adverse-cardiac-and-cerebrovascular-events(MACCE)[OR 1.65,95%-CI 1.32-2.05,p=0.000]. However, it is not associated with an increased risk of death[OR 1.7,95%-CI 1.00-2.99,p=0.048],Stroke[OR 1.24,95%-CI 0.65-2.36,p=0.512],Myocardial infraction[OR 1.56,95%-CI 1.00-2.43,p = 0.051],Suddencardiac-arrest[OR 1.12,95%-CI 0.74-1.69,p=0.603), or the necessity for Mechanical-cardiac-support[OR 1.01,95%-CI 0.59-1.72, p=0.967], Figure-2. Moreover, PPCM patients with DM exhibit an extended mean hospital stay(7.2-vs-5.7 days,p<0.000) and infaltion adjusted-cost of hospitalization ($1,02,690-vs-$84,507,p<0.00). Interestingly, these patients had a lower 30-day non-elective readmission rate (2.3% vs. 8.9%). The top three primary causes of non-elective readmission in the DM group were heart-failure, acute pericarditis, and acute kidney injury. ConclusionsOur findings show that not only do PPCM patients with DM present a higher mean age and increased baseline comorbidities, but they are also at a greater risk for acute kidney injury and significant cardiac and cerebrovascular events. Additionally, these patients undergo extended average hospital stays and incur higher infaltion adjusted hospitalization expenses.