Clinical, economic, and health care resource utilization burden of acute myocardial infarction and the role of systemic inflammation in US hospitals: A real-world study

Abstract

Background

Acute myocardial infarction (AMI), a leading cause of death in the US, is associated with significant clinical and economic burden. Systemic inflammation is a risk factor for worse cardiovascular outcomes, but the role of systemic inflammation in patients with AMI is not well established.

Objective

To evaluate clinical, health care resource utilization (HCRU), and economic outcomes in patients with type 1 AMI, and explore results based on systemic inflammation status.

Methods

Data from the Premier Healthcare Database were retrospectively analyzed, including adults with ≥1 inpatient hospitalization for type 1 AMI (using ICD-10-CM codes) from January 1, 2017, to August 31, 2023. Data were analyzed at index and within 30 and 90 days after index discharge. Demographics, clinical and HCRU outcomes, and costs were described for all patients with AMI and compared between those with and without evidence of systemic inflammation. Inflammation status was based on C-reactive protein (CRP) or high-sensitivity C-reactive protein (hsCRP) levels, such that patients with CRP/hsCRP between 2 and 10 mg/L were considered to have evidence of systemic inflammation. Patients with levels <2 mg/L or without CRP/hsCRP test results were considered to have no evidence of systemic inflammation. CRP/hsCRP test results were available in a limited number of patients.

Results

Among patients with AMI (N = 1,078,572), in-hospital mortality was 7.6 % during index hospitalization. The mean index length of stay was 5 days, and average cost of care was $23,648. Readmission rates were 7.9 % and 12.9 % within 30 and 90 days after discharge, respectively. Patients with evidence of systemic inflammation (n = 1673) had higher mortality and longer index stays as well as increased readmission rates compared with patients without evidence of systemic inflammation (n = 1,076,899) (all, P < 0.01).

Conclusion

Patients experiencing AMI, and especially those with evidence of systemic inflammation, experience persistently high risk of mortality, morbidity, recurrence, and large economic burdens. Greater attention is needed to optimize the care of this at-risk population.