Association of H2RAs exposure with 30-day mortality in patients with acute myocardial infarction in MIMIC-IV: a retrospective cohort study

Histamine H2 Receptor Antagonist (H2RAs) administration reduces mortality in critically ill patients with HF, but the association between H2RAs exposure and acute myocardial infarction (AMI) remains unclear. This study aims to investigate the relationship between H2RAs administration and 30-day mortality in critically ill patients with AMI using the MIMIC-IV 3.0 database. A retrospective cohort study was conducted using data from the MIMIC-IV 3.0 database. This study enrolled adult AMI patients and set the primary endpoint as the mortality within 30 days following hospital admission. Multivariable Cox proportional hazards models were employed to adjust for potential confounding factors, including demographic variables, comorbid conditions, and illness severity. Our analysis comprised 4252 patients with AMI, among whom 1557 received H2RAs. The overall 30-day mortality rate observed in the cohort was 13.9%. Following adjustment for confounding factors, H2RAs administration was associated with an increased hazard ratio of 1.32 (95% confidence interval: 1.09-1.6). Further subgroup analyses and propensity score assessments have validated the reliability and consistency of these results. This study revealed a significant association between H2RA administration and an increased 30-day mortality rate in myocardial infarction patients. Our findings highlight the need for further investigation to understand the underlying mechanisms and assess the clinical implications of H2RA use in this susceptible patient population.