Abstract 4342449: Effects of Cancer on Patients with Myocardial Infarction Complicated by Cardiogenic Shock: A Nationwide Inpatient Sample

Abstract

Introduction: Cardiogenic shock (CS) is a serious complication following Type 1 myocardial infarction (T1MI). Being a hypercoagulable state, active cancer has been associated with increased mortality in patients after T1MI. However, there is limited data on the impact of cancer on the outcomes of patients with T1MI complicated by CS, which our study aims to investigate. Methods: We utilized hospitalization data from the National Inpatient Sample. Our study focused on patients aged 18 and above with cancer, who were hospitalized with T1MI complicated by CS from January 2019 to December 2020. The primary outcome of interest was in-hospital mortality. We also analyzed the trends and independent predictors of mortality, and length of stay (LOS). Results: A total of 88,304 hospitalizations of T1MI complicated with CS were analyzed of which 3.5 % had active cancer. The mean age of patients with cancer was 71.5 versus 66.4 for those without, which was statistically significant (p-value<0.01), The in-hospital mortality rate was higher in those with cancer at 48 % versus 35 % in those without (p<0.01). The adjusted trend for in-hospital mortality showed a statistically significant increase from 48.1 % in 2019 to 50.2 % in 2020 (p<0.01). The independent predictors of in-hospital mortality included age, with an adjusted odds ratio (aOR) of 1.25 (p<0.03), female gender aOR 324.2 (p<0.01), liver disease a OR 836.8 (p<0.02), chronic obstructive pulmonary disease a OR 67.9 (p<0.01), and smoking aOR 76.3 (p<0.01). However, cancer was not a predictor of mortality, with aOR 3.2 (p p= 0.36; 95% CI: 0.2-45.7). Additionally, the mean length of stay did not differ significantly between the two groups (7.2 vs 8.7 days, p=0.02). Conclusion: Among patients with T1MI complicated with cardiogenic shock, those with cancer had higher in-hospital mortality. These findings highlight the importance of an early, patient-tailored approach to managing their comorbidities to improve outcomes.