The Impact of Group II Pulmonary Hypertension on Congestive Heart Failure Patients Admitted with ST Elevation Myocardial Infarction, A Nationwide Study

Objective To study the impact of group II pulmonary hypertension (PH) on the outcomes of patients admitted with ST-elevation Myocardial Infarction (STEMI), we conducted a nationwide retrospective cohort study. Patients and Methods Using the National Inpatient Sample (NIS) Database from 2017 to 2020, a retrospective study of adult patients with a principal diagnosis of STEMI with a secondary diagnosis with or without group II PH according to ICD-10 codes. Several demographics, including age, race, and gender, were analyzed. The primary endpoint was mortality, while the secondary endpoints included cardiogenic shock, mechanical intubation, length of stay in days, and patient charge in dollars. Multivariate logistic regression model analysis was used to adjust for confounders, with a p-value less than 0.05 considered statistically significant. Results The study included 27,020 patients admitted with a STEMI, 95 of whom had group II PH. The mean age for patients with and without PH was 66 and 67, respectively. In the PH group, 37% were females compared to 34% in the non-PH group. The in-hospital mortality rate was higher in the PH group (31.5% vs. 9.5%, P <.001 , aOR 3.25, P <.023 ). The rates and adjusted odds of cardiogenic shock and mechanical ventilation were higher in the PH groups (aOR 1.12 aOR 2.16, respectively) but not statistically significant. Patients with PH had a longer length of stay and a higher total charge. Conclusion Group II PH was associated with worse clinical and economic outcomes in heart failure patients admitted with STEMI.