Racial Disparities in Clinical Outcomes and Resource Utilization of Type 2 Myocardial Infarction in the United States: Insights From the National Inpatient Sample Database.

Mhanna M, Minhas AMK, Ariss RW, Nazir S, Khan SU, Vaduganathan M, Blankstein R, Alam M, Nasir K, Virani SS. Racial Disparities in Clinical Outcomes and Resource Utilization of Type 2 Myocardial Infarction in the United States: Insights From the National Inpatient Sample Database. Current problems in cardiology. 2023 Aug 1; 48(8):101202.

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Abstract:

Race-based differences in clinical outcomes have been well described in type 1 myocardial infarction. However, type 2 myocardial infarction (T2MI) is more common in contemporary practice, with scarce data regarding racial differences in outcomes. The National Inpatient Sample Database October 2017-December 2018 was queried for hospitalizations with T2MI. Complex samples multivariable logistic and linear regression models were used to determine the association between T2MI and outcomes (in-hospital mortality, length of stay [LOS], hospital costs, and discharge to facility among different racial groups (White, Black, Hispanic, and Other-races/ethnicities [Native American, Asian or Pacific Islander and others]). A total of 294,540 hospitalizations [209,565 (71.2%) White patients, 47,105 (16%) Black patients, 22,115 (7.5%) Hispanic patients, and 15,755 (5.3%) Other-races/ethnicities patients] carrying a primary or secondary diagnosis of T2MI were included in this analysis. Compared to White patients with T2MI; Other-races/ethnicities patients were associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.17; 95% confidence interval [CI]1.03-1.33; P? = 0.016), and longer LOS. Hospital costs were higher for Hispanic and Other-races/ethnicities patients compared to White patients with T2MI. Further, all the racial/ethnicity groups were less likely to be discharged to facility compared to White patients. Although Black and Hispanic patients with T2MI have similar in-hospital mortality compared with White patients, other racial minorities have higher in-hospital mortality among patients with T2MI compared to White patients. Furthermore, White patients were more likely to be discharged to a facility. Further prospective investigations of the impact of racial differences on T2MI-related in-hospital mortality and disposition are warranted.