Acute myocardial infarction in the young with diabetes mellitus- national inpatient sample study with sex-based difference in outcomes

Background: Mortality after AMI is on the decreasing trend: however, this favorable trend is not observed in the young, especially women. Therefore, we conducted a retrospective analysis using the Nationwide Inpatient Sample (MS) to identify sex-based outcomes following AMI in young with diabetes. Methods: NIS 2010-2014 was used to identify all patients with AMI using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Men (N = 30,950) and women (N = 17.928) patients diagnosed with diabetes were identified and stratified as young if age >18 and <45 years. Results: Young women with AMI and concomitant diabetes having a higher burden of overall traditional and non-traditional comorbidities. NSTEMI was the major presentation in women as compared to men. Young women with AMI and concomitant diabetes were less likely to receive revascularization with PCI [51.1% vs. 58.2%: DRUG. CI 0.78-0.94] or CABG [7.9% vs. 10.1%; OR 0.64, C10.54-0.75]. Adjusted all-cause in-hospital mortality did not differ significantly between the two groups [OR 1.06, C10.74-1.52]. Women had lower odds of developing cardiogenic shock, ventricular arrhythmias, and AKI, and were more likely to develop major bleeding requiring transfusion, and mitral regurgitation. Conclusion: There were significant differences between young men and women with diabetes in terms of baseline characteristics and clinical presentation, use of revascularization, and cardiac complications, yet overall, in-hospital mortality does not appear to differ. More studies are needed to identify the interaction of sex and diabetes in young AMI population, and areas for practice improvement. (C) 2020 Published by Elsevier B.