Impact of ST-Elevation Myocardial Infarction (STEMI) On Patients With Celiac Disease

Background Celiac Disease has links to inflammatory bowel disease (IBD), rheumatoid arthritis (RA), sarcoidosis. The latter 3 have cardiovascular manifestations There are limited studies on the hospital outcomes of Celiacs with cardiac manifestations. The aim of this study was to evaluate the economic burden and hospital outcomes of Celiacs with concomitant ST elevation myocardial infarction (STEMI). Methods Patients aged 18 years and older with Celiac disease and STEMI versus Celiac Disease alone were identified from the US Nationwide Inpatient Sample (NIS), from the years 2019-2020. ICD 10 codes were utilized, multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics. Weighted analysis utilizing Stata 17 MP was performed. Results This study identified approximately 82304 patients with Celiac Disease from the years 2019 to 2020. Of these patients, 1505 had a concomitant diagnosis of a STEMI. Mean age of patients with Celiac Disease and STEMI was 68.21 while Celiac alone was 56.27. The analysis revealed that mortality (OR 2.38, pand total hospital charges (THC) were increased ($36197, pThe length of stay between patients with Celiac disease and Celiac Disease who suffer from a STEMI were not significant at 4.5 and 5 days respectively (p<0.1333). Discussion Celiac disease is a systemic immune-mediated disorder that is triggered by an abnormal immune response to gliadin, a component of gluten1. Hallmark inflammatory response to gluten could further augment atherosclerosis, a major contributor to cardiovascular diseases1,2. Research shows a significant molecular link between Celiac disease and cardiovascular disease which involves common inflammatory pathways, endothelial dysfunction, and genetic predisposition2. Further research in this area could yield better patient outcomes. Conclusion Our study revealed that patients with Celiac Disease who have a STEMI had higher mortality, and total hospital charges compared to patients with only Celiac Disease. Common and overlapping inflammatory pathways contribute to both Celiac Disease and STEMI which likely increases the risk for complications and mortality for these patients which was demonstrated by our study. A multi-disciplinary approach should be utilized on treating patients with Celiac Disease and STEMI due to the significant morbidity and mortality. Further studies are needed to further evaluate the impact of STEMI on Celiac Disease.