SAT-581 - Inpatient Outcomes of Individuals Admitted for First-Time Myocardial Infarction with Preexisting Type 1 Diabetes Mellitus: A Nationwide Analysis 2016-2022

TITLE
Inpatient Outcomes of Individuals Admitted for First-Time Myocardial Infarction with Preexisting Type 1 Diabetes Mellitus: A Nationwide Analysis 2016-2022

RATIONALE
Myocardial infarction (MI) is characterized by an acute reduction in coronary blood flow, resulting in myocardial ischemia and cardiomyocyte necrosis. Type 1 diabetes mellitus (T1DM) is an autoimmune disease marked by immune-mediated destruction of pancreatic β-cells, leading to absolute or near-absolute insulin deficiency and necessitating lifelong exogenous insulin. Individuals with T1DM exhibit an elevated risk of cardiovascular events; however, data regarding inpatient outcomes following first-time MI in this population remain scarce. This study aimed to evaluate in-hospital outcomes, procedural utilization, and healthcare resource use among patients with T1DM admitted for their first MI, utilizing a nationally representative database.

METHODS
A retrospective cohort analysis was conducted using the National Inpatient Sample (NIS) Database from 2016-2022. Patients with a primary diagnosis of first-time MI—both ST Elevation Myocardial Infarction (STEMI) and Non-ST Elevation Myocardial Infarction (NSTEMI)—and preexisting T1DM were identified using ICD-10 codes. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), total charges, and use of interventions. Univariate analysis was performed, and variables with p< 0.2 were included in multivariate models, adjusting for demographic and hospital factors. Statistical significance was set at p< 0.05.

RESULTS
Among 1,022,535 STEMI hospitalizations, 7,100 (0.69%) had preexisting T1DM. These patients had higher odds of mortality (OR 1.31, p=0.007) and CABG (OR 1.37, p=0.004), but lower total charges ($9,565.85, p=0.041) and likelihood of coronary angiogram (OR 0.85, p=0.019). Among 2,516,739 NSTEMI hospitalizations, 25,269 (1.00%) had T1DM. These individuals also had increased odds of mortality (OR 1.35, p< 0.001), LOS (0.85, p< 0.001), total charges ($6,870.17, p=0.002), and CABG (OR 1.14, p=0.003), but decreased likelihood of coronary angiogram (OR 0.82, p< 0.001).

CONCLUSION
Patients with preexisting Type 1 Diabetes Mellitus (T1DM) hospitalized for STEMI or NSTEMI experience worse clinical outcomes, including higher odds of mortality and increased likelihood of undergoing CABG. Notably, these patients are less likely to undergo coronary angiography. While hospital charges and length of stay differ between the two groups, the consistent association with adverse outcomes highlights the need for targeted management strategies in this high-risk population.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*