P5538Asthma is associated with lower mortality from ST-segment elevation myocardial infarction and lower mortality and risk of complications from non ST-segment elevation myocardial infarction

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Background: The incidence of myocardial Infarction (MI) and prevalence of cardiovascular risk factors is higher among patients with asthma. Limited data are available about the association between the diagnosis of asthma and outcomes of different types of MI. Methods: In a retrospective cohort study, using the 2014 Nationwide Inpatient Sample (NIS), we analyzed adult patients with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) and ST-Segment Elevation Myocardial Infarction (STEMI), who had diagnosis of asthma. The goal of our study was to determine if asthma affects outcomes of different types of MI. We adjusted our results for potential confounders including age, sex, race, hospital location, hospital teaching status, insurance type, hospital bed size and the Charlson Comorbidity Index. Results: We identified 175810 patients with diagnosis of STEMI and 418835 with diagnosis of NSTEMI, who were further divided into subgroups of patients with and without asthma. In the NSTEMI asthma group (n=14150) more patients were female (58%) than in non-asthma group (40%) and patient were younger (mean age 64 and 69 years respectively). Likewise, in the STEMI asthma group (n=4415) more patients were female (47%) than in non-asthma group (31%) and patient were younger (mean age 61 and 64 years respectively). In both groups asthma was associated with lower mortality, more pronounced in NSTEMI (OR=0.53, 95% CI=0.4–0.71) than STEMI (OR= 0.67, 95% CI= 0.49–0.92) and a shorter length of stay in STEMI (Coef.= -0.33, 95% CI= -0.62– -.05) and in NSTEMI (Coef.= -.49, 95% CI=-0.68–0.31). In NSTEMI group asthma was associated with lower risk of cardiac arrest (OR=0.64, 95% CI=0.46–0.89), shock (OR=0.54, 95% CI=0.31–0.94), mechanical ventilation (OR= 0.59, 95% CI 0.47- 0.75) and dialysis due to acute kidney injury (AKI) (OR=0.27, 95% CI= 0.12–0.58). In both NSTEMI and STEMI asthma was not associated with risk of Bilevel Positive Pressure ventilation, mechanical circulatory support as well as total charges from length of stay.

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