Racial Disparities in Clinical Outcomes and Resource Utilization of Type 2 Myocardial Infarction in the United States: Insights From the National Inpatient Sample Database

Race-based differences in clinical outcomes have been well described in type 1 myocardial infarction. However, type 2 myocardial infarction (T2MI) is more common in contemporary practice, with scarce data regarding racial differences in outcomes. The National Inpatient Sample Database October 2017-December 2018 was queried for hospitalizations with T2MI. Complex samples multivariable logistic and linear regression models were used to determine the association between T2MI and outcomes (in-hospital mortality, length of stay [LOS], hospital costs, and discharge to facility among different racial groups (White, Black, Hispanic, and Other-races/ethnicities [Native American, Asian or Pacific Islander and others]). A total of 294,540 hospitalizations [209,565 (71.2%) White patients, 47,105 (16%) Black patients, 22,115 (7.5%) Hispanic patients, and 15,755 (5.3%) Other-races/ethnicities patients] carrying a primary or secondary diagnosis of T2MI were included in this analysis. Compared to White patients with T2MI; Other-races/ethnicities patients were associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.17; 95% confidence interval [CI]1.03-1.33; P = 0.016), and longer LOS. Hospital costs were higher for Hispanic and Other-races/ethnicities patients compared to White patients with T2MI. Further, all the racial/ethnicity groups were less likely to be discharged to facility compared to White patients. Although Black and Hispanic patients with T2MI have similar in-hospital mortality compared with White patients, other racial minorities have higher in-hospital mortality among patients with T2MI compared to White patients. Furthermore, White patients were more likely to be discharged to a facility. Further prospective investigations of the impact of racial differences on T2MI-related in-hospital mortality and disposition are warranted.