■我们旨在研究急性心肌梗死(AMI)对乳糜泻(CD)患者的影响。
■我们使用2011-2018年全国住院患者样本来识别18岁及以上有CD病史的患者,并使用国际疾病分类第九和第十次修订代码进行AMI。感兴趣的主要结果是有和没有CD的AMI患者的死亡率差异。次要结果是住院时间,医院费用,和冠状动脉血运重建。
■本研究共纳入2,287,840名主要诊断为AMI的加权患者。在这些人口中,183,027个加权患者有CD病史(0.08%),2,286,010例加权的AMI患者无CD病史(99.92%)。大多数有和没有CD的AMI患者年龄较大(69.57±13.21vs67.08±13.87岁,分别)和白色(92.55%和75.39%,分别)。患有AMI和CD的患者比没有CD的患者更可能是女性(53.76%vs38.47%;P<0.05)。在我们的研究中,我们发现AMI和CD的住院费用差异(调整后平均差2644.7美元)较低;然而,CD患者的住院时间较高(校正平均差异0.36天),但无统计学意义(P>.05).这两个队列的医疗保险接受者人数较多,而自费的患者人数较少。我们的研究还发现,吸烟在CD患者中更为普遍,12.14%,与没有CD的患者相比,2.51%。此外,患AMI的CD患者的校正后死亡率低于无CD患者(校正后的比值比[aOR]0.41;P<.05).患有CD和AMI的患者冠状动脉血运重建的几率也较低(aOR为0.80;P<0.05)。此外,我们发现,患有CD的成年人患AMI的几率较低(aOR0.78;P<0.05)。
■CD是一种慢性疾病,可导致慢性炎症和各种营养相关问题,可导致病态增加。然而,我们发现CD患者患AMI的几率较低,以及与AMI相关的较低死亡率和合并症,因此与先前的假设相矛盾。
UNASSIGNED: We aimed to study the impact of acute myocardial infarction (AMI) in patients with celiac disease (CD).
UNASSIGNED: We used the National Inpatient Sample 2011-2018 to identify patients aged 18 years and older with a history of CD who presented with AMI using International Classification of Disease Nineth and Tenth Revision codes. Primary outcome of interest was mortality differences in AMI patients with and without CD. Secondary outcomes were in-hospital length of stay, hospital costs, and coronary revascularization.
UNASSIGNED: A total of 2,287,840 weighted patients were included in this study with a principal diagnosis of AMI. Among this population, 183,027 weighted patients had a history of CD (0.08%), and 2,286,010 weighted patients had AMI without a history of CD (99.92%). Most AMI patients with and without CD were older (69.57 ± 13.21 vs 67.08 ± 13.87 years, respectively) and white (92.55% vs 75.39%, respectively). Patients with AMI and CD were more likely to be female than patients without CD (53.76% vs 38.47%; P < .05). In our study, we found that the difference in hospital charges (adjusted mean difference $2644.7) was lower among AMI and CD; however, length of stay was higher among patients with CD (adjusted mean difference 0.36 day) although they were not statistically significant (P > .05). Both cohorts had higher number of Medicare recipients and lower number of patients who self-pay. Our study also found that smoking was more prevalent among patients with CD, 12.14%, vs patients without CD, 2.51%. Moreover, patients with CD who developed AMI had a lower adjusted odds of mortality than those without CD (adjusted odds ratio [aOR] 0.41; P < .05). Patients with CD and AMI also had lower odds of coronary revascularization (aOR 0.80; P < .05). In addition, we found that adults with CD had a lower odds of developing AMI (aOR 0.78; P < .05).
UNASSIGNED: CD is a chronic disease leading to chronic inflammation and various nutrition-related problems which can lead to increased morbid conditions. However, we found lower odds of AMI among patients with CD, as well as lower mortality and comorbidities related to AMI, thus contradicting previous assumptions.