This study aimed to determine predictors of prolonged length of stay (LOS) and mortality in female STEMI
patients with diabetes in comparison to female STEMI patients without diabetes. This retrospective single-center
study was conducted between 2015 and 2020 as part of the STEMI registry in our center and included all STEMI
patients.
Results: Out of 3081 STEMI patients, 16% (N = 498) were female, and 64% (n = 318) of them had diabetes.
Diabetic patients were less commonly presented with anterior wall myocardial infarction (AWMI) (47% vs 65%,
p = 0.001), but tended to have a higher prevalence of left main (LM) significant disease compared to nondiabetic patients (4% vs 1%, p = 0.06). Of the patients, 36% had prolonged LOS (≥5 days), and they were
more obese with a higher incidence of hemoglobin drop ≥ 3 g/dL, higher admission troponin, and peak creatinine. 22% of patients with prolonged LOS came to the hospital after receiving lytic therapy and showed a higher
prevalence of multivessel stenosis. Prolonged LOS patients had a higher incidence of pulmonary edema and
cardiac arrest, which necessitated ventilation, although they did not show a significant difference in mortality
from the group with LOS < 5 days. Our study found a significant negative correlation between glycosylated
hemoglobin (HbA1c) and left ventricular ejection fraction (LVEF) (p = 0.02), but a positive correlation was
noticed between HbA1c and LOS (p < 0.001). Regression analysis showed that diabetes mellitus, hemoglobin
drop, creatinine level, and LVEF were significant predictors of prolonged LOS among females, although HbA1c,
BMI ≥ 30, STEMI type, and peak creatinine level were independent predictors of prolonged LOS among female
diabetic patients. Age ≥ 65 years and LVEF were significant independent predictors of mortality (p = 0.04, 0.02
respectively) in STEMI female patients.
Conclusions: Diabetes mellitus, bleeding, renal impairment, and LVEF were found to be significant independent
predictors of prolonged LOS among STEMI females. Age ≥ 65 years and LVEF were significant predictors of
mortality among STEMI female patients. |
