Associations between periodontal disease and hospitalization outcomes in ST-segment elevation myocardial infarction: Insights from the National Inpatient Sample

Abstract

Background: Periodontal disease (PD) is linked to increased cardiovascular morbidity, but its impact on outcomes in ST-segment elevation myocardial infarction (STEMI) remains understudied. The authors investigated the effect of PD on STEMI outcomes.

Methods: The authors analyzed STEMI hospitalizations from the 2016-2019 National Inpatient Sample data set, comparing outcomes in patients with and without PD. Primary and secondary outcomes included mortality, mechanical circulatory support, mechanical ventilation, vasopressor use, cardiogenic shock, acute kidney injury, hospital length of stay, and total hospital cost. Multivariable regression adjusted for confounding factors.

Results: Of 2,595,584 STEMI hospitalizations, 0.2% involved patients with an InternationalClassification of Diseases, Tenth Revision, Clinical Modification code for PD. A PD code was associated with higher odds of mechanical circulatory support use (adjusted OR [aOR], 1.57; 95% CI, 1.25 to 1.97), mechanical ventilation (aOR, 1.26; 95% CI, 1.01 to 1.58), cardiogenic shock (aOR, 1.48; 95% CI, 1.20 to 1.83), acute kidney injury (aOR, 1.32; 95% CI, 1.13 to 1.55), longer hospital stays (7.18 vs 4.40 days; P < .001), and higher hospital costs ($141,245 vs $98,152; P < .001). Mortality and vasopressor use were unchanged.

Conclusions: Among STEMI cases, a concomitant PD code was associated with higher odds of nonfatal adverse events and health care resource use.

Practical implications: Recognizing PD as a comorbidity in STEMI may help tailor care strategies, reduce adverse outcomes, and improve resource allocation in clinical practice. Further studies could refine risk-stratification approaches.

Keywords: Periodontal disease; acute myocardial infarction; outcome analysis.