Type II myocardial infarction in adults hospitalized for severe asthma was associated with significantly higher mortality (10.3% vs 2.9%; aOR 3.50, 95% CI 1.21-10.11, p=0.021).
Cross-Sectional (n=19,335)
Yes
What are the incidence, predictors, and mortality burden of Type II myocardial infarction in adults hospitalized for severe persistent asthma with status asthmaticus?
Type II myocardial infarction is an uncommon but highly morbid complication in adults hospitalized for severe asthma, associated with a 3.5-fold increased odds of mortality.
Effect estimate: aOR 3.50 (95% CI 1.21-10.11)
Absolute Event Rate: 10.3% vs 2.9%
p-value: p=0.021
Abstract Rationale Severe persistent asthma with status asthmaticus is a life-threatening condition associated with substantial morbidity and mortality. Type II myocardial infarction (T2MI), resulting from an imbalance in myocardial oxygen supply and demand without coronary thrombosis, may occur during systemic stress but remains underexplored in this setting. Acute hypoxemia, systemic inflammation, and β-agonist use may contribute to myocardial injury. This study aimed to determine the incidence, predictors, and mortality burden of T2MIamong adults hospitalized for severe asthma. Methods A retrospective cross-sectional analysis was performed using the National Inpatient Sample (2018-2022). Adults (≥18 years) admitted with severe persistent asthma and status asthmaticus were included; COVID-19-positive cases were excluded. T2MI was identified using the ICD-10 code “I21A1”. Multivariable logistic regression was used to identify predictors of T2MI. We further assessed complications observed among them. Results Of 19, 335 admissions, 195 developed Type II MI (1, 009 per 100, 000). These patients were older (53. 0 vs 41. 7 years, p 0. 01) and had higher comorbidity scores (mean Charlson Comorbidity Index scores of 3. 03 vs 1. 52, p 0. 01). Independent predictors included age (adjusted odds ratio aOR: 1. 041, 95% CI: 1. 013 - 1. 069, p = 0. 003), preexisting congestive heart failure (aOR: 5. 130, 95% CI: 1. 869 - 14. 084, p = 0. 002), and alcohol abuse (aOR: 4. 713, 95% CI: 1. 447 - 15. 351, p = 0. 010). No significant differences were observed for seasonality, sex, race, insurance type, or other comorbidities. Mortality was higher in T2MI patients (10. 3% vs 2. 9%; aOR 3. 50, 95% CI 1. 21-10. 11, p = 0. 021). Complications included cardiogenic shock (12. 8%), cardiac arrest (10. 3%), and mechanical ventilation (51. 3%). T2MI was also associated with longer stays (9. 9 vs 5. 4 days, p 0. 01) and higher hospital charges (207k vs 81k, p 0. 01). Conclusion T2MI in severe asthma is uncommon but linked to markedly higher mortality and complications. Older age, heart failure, and alcohol abuse are key predictors, highlighting the need for close interdisciplinary collaboration, to optimize the outcomes of this high-risk population. This abstract is funded by: None
Dhaliwal et al. (2026) conducted a cross-sectional in Severe persistent asthma with status asthmaticus (n=19,335). Type II myocardial infarction vs. No Type II myocardial infarction was evaluated on Mortality (aOR 3.50, 95% CI 1.21-10.11, p=0.021). Type II myocardial infarction in adults hospitalized for severe asthma was associated with significantly higher mortality (10.3% vs 2.9%; aOR 3.50, 95% CI 1.21-10.11, p=0.021).