Incidence and In-Hospital Outcomes of Bradycardia or Atrioventricular Conduction Disorder in Patients With Type 2 Myocardial Infarction: A Nationwide Inpatient Analysis

Incidence and In-Hospital Outcomes of Bradycardia or Atrioventricular Conduction Disorder in Patients With Type 2Myocardial Infarction: A Nationwide Inpatient Analysishttps://doi.org/10.1002/joa3.70243ABSTRACTBackgroundType 2 myocardial infarction (T2MI), caused by an imbalancebetween oxygen supply and demand without significant coronary obstruction, is increasingly recognized yet remains underexplored, particularly regarding conduction abnormalities.MethodsWe conducted a retrospective cohort study using the NationalInpatient Sample from 2017 to 2022. Adult patients hospitalized with Type 2 myocardial infarction were identified by ICD-10-CM code. Bradycardia or atrioventricular (AV) conduction delay was defined using diagnostic codes forbradycardia and all degrees of atrioventricular block. We compared baseline characteristics, comorbidities, and causes of Type 2 myocardial infarction, and used multivariable logistic regression to evaluate associations with in-hospitalmortality and cardiogenic shock.ResultsAmong 1 960 410 patients with Type 2 myocardial infarction, 118 025 (6.0%) had bradycardia or atrioventricular conduction delay. These patients were older, more often male, and had higher rates of hypertension, heart failure, chronic kidney disease, and diabetes. The pacemaker implantation wassignificantly more prevalent (8.7% vs. 0.3%, p < 0.01). They also showed an increase in in-hospital mortality (10.4% vs. 9.8%, p < 0.01), cardiogenic shock (5.1% vs. 3.2%, p < 0.01), and AKI (47.9% vs. 46.3%, p < 0.01). After adjustment, conduction disorders remained associated with higher odds of mortality (aOR 1.09, 95% CI 1.04–1.14) and cardiogenic shock (aOR 1.71, 95% CI 1.61–1.83). ConclusionsBradycardia or atrioventricular conduction delay occurred in6% of Type 2 myocardial infarction hospitalizations and wasindependently linked to worse in-hospital outcomes, underscoring the need for close monitoring in this population. Disclaimer:Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.