Search

Introduction: An obesity paradox is observed in patients with diabetes. Hypothesis: We hypothesized that obese patients with diabetes hospitalized for STEMI have a better intra-hospital outcome. Methods: We used data from the National Inpatient Sample (NIS) from 2008 to 2014. Patients with STEMI and diabetes were classified according to their BMI: Underweight (BMI 40). We compared different classes and assessed in-hospital events. Results: 1.7% patients were underweight, 3.0% had normal weight, 10.4% had Obesity Class I, 54.8% had Obesity Class II, and 30.2% had Obesity Class III. Mean age (SD) was higher in underweight patients (73 ±13) but decreases progressively to reach 58 ± 11 in class III obesity (p84 years old). Multivariable adjustments did not affect the significance of the results. Conclusions: An obesity paradox is observed in patients with diabetes hospitalized for STEMI. Higher BMI is correlated with lower risk of mortality, cardiogenic shock, and atrial fibrillation. Underweight patients did not have a higher risk of cardiovascular events.

Introduction: Diabetes is associated with increased cardiovascular complications. Hypothesis: We hypothesized that patients hospitalized for aortic valve repair have a worse outcome in the presence of diabetes. Methods: Data from the National Inpatient Sample (NIS) was analysed between 2012 to 2017. We compared hospitalization, in-hospital cardiovascular outcomes and socio-economic outcomes between patients with diabetes vs non-diabetes hospitalized for SAVR and TAVR. Results: In diabetes patients undergoing TAVR, mean age of participants decreased from 79.6 ±8 to 67.8 ±8, total cases increased from the number of cases increased from 2280 to 18940 (p Conclusions: Mortality and other cardiovascular outcomes are decreasing with time in patients with diabetes undergoing aortic valve repair. In TAVR patients, there was no difference in the burden of diabetes on mortality. However, SAVR patients with diabetes still experience a higher mortality rate. Nevertheless, most post-procedural complications are higher in the presence of diabetes

Introduction: Hyperglycemia in patients admitted for STEMI is associated with a worse outcome Hypothesis: We hypothesized that hypoglycemia in patients hospitalized for STEMI is also associated with a higher morbidity and mortality. Methods: We used data from the National Inpatient Sample (2005-2017) to identify adult patients admitted with STEMI as the primary diagnosis. Secondary diagnosis was hypoglycemia. We compared cardiovascular and socio-economic outcomes between STEMI patients with and without hypoglycemia and assessed temporal trends. Results: Hypoglycemia tends to complicate 0.117% of all cases hospitalized for STEMI. The mean age of STEMI patients hospitalized with hypoglycemia has been slightly trending down, from 67.40 ± 15 in 2005 to 63.86 ± 12 in 2017 (p=0.046). Mortality was stable with time, but the prevalence of ventricular tachycardia (VTach) and ventricular fibrillation (Vfib) decreased, total charges and length of stay (LOS) increased. Compared to non-hypoglycemic patients, those with developed hypoglycemia were older, more also likely to be males (64.4%) and whites (72.1%), only 6.7% had a history of diabetes as compared to 28.5% in STEMI patients (p=0.001). Cardiovascular events were more likely to occur in the presence of hypoglycemia: mortality risk increased by almost 4-fold (4.490 [4.174 - 5.848]. There was also a higher risk of cardiogenic shock (OR= 1.718 [21.387 - 2.127], VFib (OR=1.799 [1.406 - 2.301]), AF (OR=1.28 [1.025 - 1.607]), acute renal failure (OR= 2.355 [1.902 - 2.917] but not stroke (all ORs were adjusted, including on the presence of diabetes). Patients who developed hypoglycemia were less likely to have PCI (OR= 0.488 [0.417 - 0.571] but more likely to have CABG (OR= 2.259 [1.814 - 2.814]. They had a longer in-hospital stay and cost more than non-hypoglycemia patients. Sensitivity analysis though propensity-score matching confirmed our findings. Conclusions: Hypoglycemia was found to complicate 0.117% of all patients hospitalized with STEMI. Patients with hypoglycemia were found to have higher odds of mortality and cardiovascular complications during their hospital stay compared to patients without hypoglycemia, irrespective of the presence of diabetes at baseline.

Introduction: Diabetes is a widely prevalent pathology complicating many cardiovascular diseases. Hypothesis: We hypothesized that patients with hypertrophic cardiomyopathy (HCM) hospitalized for heart failure (HF) have a worse outcome in the presence of diabetes. Methods: The National Inpatient Sample (NIS) was analysed to identify records from 2005-2015 of patients hospitalized for HF as a complication of HCM. We assessed the cardiovascular and socio-economic trend of patients with diabetes and HCM hospitalized for HF, and compared them to those without diabetes. Results: Diabetes prevalence increased from 24.8% to 32.7% in all HMC patients hospitalized for HF. In diabetes patients, mean age of patients decreased from 71 ±13 to 67.6 ±14.2 (p Conclusions: Diabetes is paradoxically associated with lower mortality and lower rates of complications (namely arrhythmias) in HCM patients hospitalized for HF