OR6-6 | In-Hospital Outcomes of Post-Myocardial Infarction Complications In Patients Without Standard Modifiable Risk Factors: A Nationwide Analysis

Recent studies show that patients without standard modifiable risk factors (SMuRF-less) have poorer outcomes in acute myocardial infarction (AMI). This study explores the risk of post-myocardial infarction complications in this subset of patients, which has not yet been studied. This is a retrospective study using the National Inpatient Sample for hospitalizations between 2017 - 2019. ICD-10 codes identified patients presenting with AMI divided into those with and without SMuRFs (diabetes mellitus, hyperlipidemia, hypertension, and smoking). The outcomes of interest were mortality and post-AMI complications. Multivariate logistic analysis was used to adjust for age, gender, race, location, and relevant co-morbidities with a p-value <0.2 in univariate screen. 3,476,360 patients were hospitalized with AMI, of which 11.7% were SMuRF-less. Compared to those with one or more SMuRFs, SMuRF-less patients have increased adjusted odds of mortality (OR 2.65, 95% CI 2.58 - 2.72) and post-AMI complications including hemopericardium (OR 2.90, 95% CI 1.79 - 4.79), wall rupture (OR 2.52, 95% CI 1.69 - 3.77), cardiogenic shock (OR 1.84, 95% CI 1.78 - 1.89) and cardiac arrest (OR 1.95, 95% CI 1.89 - 2.02). We observed a substantial increase in the likelihood of post-AMI complications in SMuRF-less patients. This further underscores the need to recognize non-conventional risk factors in coronary artery disease. Future studies may help to clarify these associations.