Abstract 230: Prediabetes In Young Adults And Its Association With Type 1 Myocardial Infarction-related Admissions And Outcomes: A Population-based Analysis In The United States

Abstract

Background: Prediabetes (pDM) has recently drawn attention for being associated with poor outcomes after acute myocardial infarction (MI). We aimed to analyze the incidence and odds of type 1 MI admissions, and outcomes using a nationally representative sample. Methods: We queried the National Inpatient Sample (2018) to identify T1MI-related hospitalizations (T1RH) in young (18-44 years) adults with vs without pDM using ICD-10 codes. T1RHs with DM were excluded. Demographics, comorbidities and outcomes including major cardiovascular and cerebrovascular adverse events (MACCE) were compared between two cohorts. Results: Overall prevalence of pDM in young adults hospitalized in 2018 was 0.4% (31460/7851019). T1RH was found to be significantly higher in the pDM vs. non-pDM cohort (2.15%, 675/31460 vs. 0.3%, 21655/7820953) among all non-diabetic admissions in young adults. T1RH with pDM often had males (78.5 vs 72.8%), blacks (26.7 vs 21%), Hispanics (18.3 vs 11.5%), Asian/Pacific Islanders (6.9 vs 3.1%), patients from higher-income quartile (19.1 vs 15.8%), urban-teaching (81.5 vs 72.2%), Midwest (23.7 vs 21.9%) and West (23 vs 16.4%) region hospitals, and patients with higher rates of hyperlipidemia (68.1 vs 47.3%), obesity (48.9 vs 25.7%), fluid-electrolyte imbalance (18.5 vs 15.3%). The univariate (OR 7.9, 95CI 6.54-9.53) and adjusted multivariate analysis (OR 1.71, 95CI 1.38-2.12) revealed significantly higher odds of T1MI in the pDM vs non-pDM cohort (p<0.001) [Table 1] . However, T1RH’s outcome for MACCE (adjusted) did not differ between two cohorts (P=0.074). Furthermore, T1RH with pDM had higher transfers to short-term facilities (6.7 vs 5.3%, p<0.001). Conclusion: Young patients with prediabetes had significantly higher T1MI hospitalizations without any impact on subsequent MACCEs. This highlights the need for aggressive management of CVD risk factors in the young by primary care physicians to curtail acute cardiac events and healthcare costs.