Ventricular arrhythmias in type 2 myocardial infarction: Incidence and in-hospital outcomes: A national inpatient analysis (2017–2022)

Abstract

Background: Ventricular arrhythmias, including ventricular tachycardia and ventricular fibrillation, are well-known contributors to adverse outcomes in type 1 myocardial infarction, but their significance in type 2 myocardial infarction remains underexplored.

Objective: We aim to investigate the incidence of ventricular arrhythmias and their association with clinical outcomes among patients with type 2 myocardial infarction.

Methods: This retrospective cohort study utilized the National Inpatient Sample (2017–2022) and included adults hospitalized for type 2 myocardial infarction. Ventricular arrhythmias were identified using ICD-10-CM codes. Multivariable models were adjusted for patients’ demographics and comorbidities and employed to identify predictive factors for in-hospital mortality, length of stay, and total hospital charges.

Results: A total of 2,016,430 patients were included, and 5.89% developed ventricular arrhythmias. Patients with ventricular arrhythmias were younger (69.5 vs. 70.6 years, p<0.01), less female (33.4% vs. 47.9%, p<0.01), and more frequently African American (20.1% vs 17.0%, p<0.01). Ventricular arrhythmias were associated with significantly increased in-hospital mortality (19.3% vs. 9.2%, p<0.01), prolonged hospital length of stay (7 vs 5 days), and higher total hospital charges ($99,437 vs. $60,297 p<0.01). Adjusted multivariate models demonstrated ventricular arrhythmias as an independent predictor for in-hospital mortality (aOR 2.39, 95% CI 2.31-2.48), longer length of stay (β 2.83 days, 95% CI 2.66–3.00), and higher total hospital charges (cost ratio 1.60, 95% CI 1.57–1.63).

Conclusion: The incidence of ventricular arrhythmias is notable among hospitalized patients with type 2 myocardial infarction is associated with significantly worse clinical and economic outcomes.