# Impact of Rhabdomyolysis on Clinical Outcomes in Patients With Acute Myocardial Infarction

## TL;DR

This study finds that patients with both heart attacks and rhabdomyolysis face significantly worse hospital outcomes, including higher death rates and more complications.

## Contribution

This study quantifies the increased risk of severe outcomes in patients with acute myocardial infarction and rhabdomyolysis using a large national database.

## Key findings

- Patients with AMI and rhabdomyolysis had a 2.38 times higher in-hospital mortality rate compared to those with AMI alone.
- Rhabdomyolysis was strongly associated with acute kidney injury (aOR 5.13) and prolonged hospital stays.
- These patients were less likely to receive percutaneous coronary intervention compared to those with AMI alone.

## Abstract

Background: Acute myocardial infarction (AMI) is a major cause of death and disability worldwide. The clinical outcomes of the co-occurrence of rhabdomyolysis and AMI are not very well studied. The aim of this study is to analyze the impact of rhabdomyolysis on the clinical outcomes in patients with AMI.

Methods: Between 2018 and 2021, patients diagnosed with AMI and rhabdomyolysis were identified using the National Inpatient Sample and ICD-10 codes. A multivariate regression analysis was conducted using STATA software (Stata Corp., College Station, TX).

Results: A total of 2,467,290 hospitalizations diagnosed with AMI were identified. Of those, 17,800 had a co-diagnosis of rhabdomyolysis. Compared to patients with AMI alone, patients with AMI and rhabdomyolysis had a higher in-hospital mortality rate (2,965 (16.65%) vs. 113,455 (4.63%), adjusted odds ratio (aOR) 2.38, p<0.0001), cerebrovascular accidents (CVAs) (740 (4.2%) vs. 30,740 (1.25%), aOR 2.13, p<0.0001), cardiogenic shock (3,530 (19.83%) vs. 169,490 (6.92%), aOR 2.24, p<0.0001), acute kidney injury (AKI) (10,660 (59.89%) vs. 503,815 (20.57%), aOR 5.13, p<0.0001), need for hemodialysis (1,105 (6.2%) vs. 85,160 (3.48%), aOR 1.94, p<0.0001), and prolonged length of stay (LOS) (aOR 1.98, p<0.0001). There was no statistical significance between the two groups in developing acute heart failure (4,765 (26.77%) vs. 4,899 (20.9%), aOR 0.92, p=0.112). Additionally, patients with rhabdomyolysis and AMI were less likely to undergo percutaneous coronary intervention (3,240 (18.2%) vs. 786,286 (32.1%), p<0.0001).

Conclusion: Patients who had AMI with rhabdomyolysis had substantially worse in-hospital outcomes, including higher in-hospital mortality rates, higher risks of developing CVAs, cardiogenic shock, AKI, hemodialysis, and longer LOS.