Neppala S, Chigurupati HD, Chauhan S, Chinthapalli MT, Desai R. Impact of depression on in-hospital outcomes for adults with type 2 myocardial infarction: A United States population-based analysis. World J Cardiol 2024; 16(7): 412-421 [PMID: 39086894 DOI: 10.4330/wjc.v16.i7.412]
Corresponding Author of This Article
Shaylika Chauhan, FACP, MD, Clinical Assistant Professor (Honorary), Department of Internal Medicine, Geisinger Health System, 1000 E Mountain Blvd, Wikes-Barre, PA 18702, United States. drshaylikachauhan@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sivaram Neppala, Department of Internal Medicine, University of Texas at San Antonio, San Antonio, TX 78249, United States
Himaja Dutt Chigurupati, Department of Internal Medicine, New York Medical College at Saint Michael’s Medical Center, Newark, NJ 07102, United States
Shaylika Chauhan, Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States
Mrunal Teja Chinthapalli, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
Rupak Desai, Independent Researcher, Atlanta, GA 30079, United States
Author contributions: Neppala S and Desai R contributed to the resources of this manuscript; Neppala S, Chigurupati HD, Chinthapalli MT, and Desai R participated in the writing-original draft of this article; Neppala S, Chauhan S, and Desai R were involved in the visualization; Chigurupati HD, Chauhan S, Chinthapalli MT, and Desai R took part in the writing - review & editing; Chauhan S and Desai R contributed to the conceptualization and methodology of this manuscript; Chauhan S participated in the supervision of this study; Desai R contributed to the software and formal analysis of this manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: Not applicable, data is obtained from a publicly available data set, patient identifiers are not used.
Informed consent statement: Informed consent statement was not obtained from the patients as there is no patient-identifiable data included in this observational study from the National Inpatient Sample database.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available on request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shaylika Chauhan, FACP, MD, Clinical Assistant Professor (Honorary), Department of Internal Medicine, Geisinger Health System, 1000 E Mountain Blvd, Wikes-Barre, PA 18702, United States. drshaylikachauhan@gmail.com
Received: March 5, 2024 Revised: May 30, 2024 Accepted: June 25, 2024 Published online: July 26, 2024 Processing time: 140 Days and 21.9 Hours
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. However, though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction (T1MI), data remains non-existent to evaluate the association with T2MI.
AIM
To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital outcomes.
METHODS
We queried the National Inpatient Sample (2019) to identify T2MI hospitalizations using Internal Classification of Diseases-10 codes in hospitalized adults (≥ 18 years). In addition, we compared sociodemographic and comorbidities in the T2MI cohort with vs without comorbid depression. Finally, we used multivariate regression analysis to study the odds of T2MI hospitalizations with vs without depression and in-hospital outcomes (all-cause mortality, cardiogenic shock, cardiac arrest, and stroke), adjusting for confounders. Statistical significance was achieved with a P value of < 0.05.
RESULTS
There were 331145 adult T2MI hospitalizations after excluding T1MI (median age: 73 years, 52.8% male, 69.9% white); 41405 (12.5%) had depression, the remainder; 289740 did not have depression. Multivariate analysis revealed lower odds of T2MI in patients with depression vs without [adjusted odds ratio (aOR) = 0.88, 95% confidence interval (CI): 0.86-0.90, P = 0.001]. There was the equal prevalence of prior MI with any revascularization and a similar prevalence of peripheral vascular disease in the cohorts with depression vs without depression. There is a greater prevalence of stroke in patients with depression (10.1%) vs those without (8.6%). There was a slightly higher prevalence of hyperlipidemia in patients with depression vs without depression (56.5% vs 48.9%), as well as obesity (21.3% vs 17.9%). There was generally equal prevalence of hypertension and type 2 diabetes mellitus in both cohorts. There was no significant difference in elective and non-elective admissions frequency between cohorts. Patients with depression vs without depression also showed a lower risk of all-cause mortality (aOR = 0.75, 95%CI: 0.67-0.83, P = 0.001), cardiogenic shock (aOR = 0.65, 95%CI: 0.56-0.76, P = 0.001), cardiac arrest (aOR = 0.77, 95%CI: 0.67-0.89, P = 0.001) as well as stroke (aOR = 0.79, 95%CI: 0.70-0.89, P = 0.001).
CONCLUSION
This study revealed a significantly lower risk of T2MI in patients with depression compared to patients without depression by decreasing adverse in-hospital outcomes such as all-cause mortality, cardiogenic shock, cardiac arrest, and stroke in patients with depression.
Core Tip: We studied the prevalence and risk of type 2 myocardial infarction (T2MI) in adults with depression and its impact on the in-hospital outcomes which revealed a significantly lower risk of T2MI in patients with depression compared to patients without depression by decreasing adverse in-hospital outcomes. Our study revealed decreased risks of all-cause mortality, cardiogenic shock, and cardiac arrest during T2MI hospitalization in patients with depression.
