부산대학교 도서관

Introduction and Objective There is a paucity of data on patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and a decompensated diabetic state, diabetic ketoacidosis (DKA). Therefore, we aimed to investigate the outcomes of patients with MINOCA presenting with or without DKA. Methods We conducted this retrospective propensity score-matched analysis from January 1, 2015, to December 4, 2022. The patients with a principal admission diagnosis of ST-Elevation MI (STEMI) and discharge labeled as MINOCA (ICD-10-CM code 121.9) with DKA were analyzed. We performed a comparative analysis for MINOCA with and without DKA before and after propensity score matching for primary and secondary endpoints. Results Three thousand five hundred sixty-three patients were analyzed, and 1150 (32.27%) presented with DKA, while 2413 (67.72%) presented as non-DKA. The DKA cohort had over two-fold mortality (5.56% vs. 1.19%; p = 0.024), reinfarction (5.82% vs. 1.45%; p = 0.021), stroke (4.43% vs. 1.36%; p = 0.035), heart failure (6.89% vs. 2.11%; p = 0.033), and cardiogenic shock (6.43% vs. 1.78%; p = 0.025) in a propensity score-matched analysis. There was an increased graded risk of MINOCA with DM (RR (95% CI): 0.50 (0.36-0.86; p = 0.023), DKA (RR (95% CI): 0.46 (0.24-0.67; p = 0.001), and other cardiovascular (CV) risk factors. Conclusion DKA complicates a portion of MINOCA and is associated with increased mortality and major adverse cardiovascular events (MACE). Keywords: Myocardial infarction, Diabetic ketoacidosis, Percutaneous coronary intervention, Coronary angiography
Author(s): Asif Ullah[sup.1], Umar Khan[sup.2], Shumaila Asif[sup.3], Hafiz Muhammad Shafique[sup.3], Talha Sajid[sup.4], Jateesh Kumar[sup.5], Waheed Akhtar[sup.6], Syed Muhammad Jawad Zaidi[sup.7], Jahanzeb Malik[sup.7] and Amin Mehmoodi[sup.8] Introduction One of the significant [...]