Abstract Rationale Type 2 myocardial infarction (T2MI) frequently occurs in the setting of septic shock and may contribute to adverse cardiopulmonary outcomes. Although sepsis-related myocardial injury is well recognized, the independent impact of T2MI on cardiac and pulmonary outcomes in this critically ill population remains unclear. This study aimed to evaluate cardiopulmonary outcomes in patients with septic shock with and without T2MI. Methods We conducted a retrospective, propensity score-matched cohort study using the TriNetX Research Network. Adult patients aged 18 years and older diagnosed with septic shock were classified according to the presence or absence of T2MI during the index hospitalization. After 1:1 propensity matching, 56,188 patients were included in the analysis. Matching was based on demographics, comorbidities, and cardiovascular risk factors. Cardiopulmonary outcomes were compared between groups at 7, 30, 90, and 180 days. These outcomes included all-cause mortality, intubation, respiratory arrest, cardiogenic shock, stroke, heart failure, systolic heart failure, acute myocardial infarction, percutaneous coronary intervention or coronary artery bypass grafting, need for advanced mechanical circulatory support, supraventricular tachycardia, and ventricular tachycardia. Outcomes were analyzed using Kaplan-Meier survival estimates and Cox proportional hazards models to determine hazard ratios (HRs) and 95 percent confidence intervals (CIs). Results Compared with matched patients with septic shock without T2MI, those with T2MI had a higher need for intubation at 7 days (HR 1.349, 95% CI 1.287-1.416). T2MI was also associated with increased all-cause mortality at 30 days (1.039 1.008-1.069) and 90 days (1.049 1.022-1.077). At 90 days, patients with T2MI had a greater risk of cardiogenic shock (1.209 1.027-1.423), and this association persisted at 180 days (1.269 1.089-1.477). Additionally, stroke risk was higher at 180 days (1.197 1.047-1.369). Conclusion In patients with septic shock, T2MI was associated with higher risks of intubation, all-cause mortality, cardiogenic shock, and stroke. These findings suggest that T2MI identifies a higher-risk subgroup that may warrant closer cardiopulmonary monitoring and management. This abstract is funded by: None
Chaaban et al. (Fri,) studied this question.