Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov;18(11):1064-71.
doi: 10.1002/pds.1821.

An algorithm to identify incident myocardial infarction using Medicaid data

Neesha N Choma  1 , Marie R Griffin, Robert L Huang, Edward F Mitchel Jr, Lisa A Kaltenbach, Patricia Gideon, Shannon M Stratton, Christianne L Roumie
Affiliations

An algorithm to identify incident myocardial infarction using Medicaid data

Neesha N Choma et al. Pharmacoepidemiol Drug Saf. 2009 Nov.

Abstract

Purpose: Studies of non-steroidal anti-inflammatory drugs (NSAIDs) and cardiovascular events using administrative data require identification of incident acute myocardial infarctions (AMIs) and information on whether confounders differ by NSAID status.

Methods: We identified patients with a first AMI hospitalization from Tennessee Medicaid files as those with primary ICD-9 discharge diagnosis 410.x and hospitalization stay of > 2 calendar days. Eligible persons were non-institutionalized, aged 50-84 years between 1999-2004, had continuous enrollment and no AMI, stroke, or non-cardiovascular serious medical illness in the prior year. Of 5524 patients with a potential first AMI, a systematic sample (n = 350) was selected for review. Using defined criteria, we classified events using chest pain history, EKG, and cardiac enzymes, and calculated the positive predictive value (PPV) for definite or probable AMI.

Results: 337 of 350 (96.3%) charts were abstracted and 307 (91.1%), 6 (1.8%), and 24 (7.1%) events were categorized as definite, probable, and no AMI, respectively. PPV for any definite or probable AMI was 92.8% (95% CI 89.6-95.2); for an AMI without an event in the past year 91.7% (95% CI 88.3-94.2), and for an incident AMI was 72.7% (95% CI 67.7-77.2). Age-adjusted prevalence of current smoking (46.4% vs. 39.1%, p = 0.35) and aspirin use (36.9% vs. 35.9%, p = 0.90) was similar among NSAID users and non-users

Conclusions: ICD-9 code 410.x had high predictive value for identifying AMI. Among those with AMI, smoking and aspirin use was similar in NSAID exposure groups, suggesting these factors will not confound the relationship between NSAIDs and cardiovascular outcomes.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study cohort and systematic sample selected for chart review
See this image and copyright information in PMC

References

    1. Petersen LA, Wright S, Normand ST, et al. Positive predictive value of the diagnosis of acute myocardial infarction in an administrative database. J Gen Intern Med 1999; 14(9): 555–558. DOI: jgi10198 [pii] - PMC - PubMed
    1. Kiyota Y, Schneeweiss S, Glynn RJ, et al. Accuracy of medicare claims-based diagnosisof acute myocardial infarction: estimating positive predictive value on the basis of reviewof hospital records. Am Heart J 2004; 148(1): 99–104. DOI: 10.1016/j.ahj.2004.02.013S000287030400184X [pii] - DOI - PubMed
    1. Fisher ES, Whaley FS, Krushat WM, et al. The accuracy of Medicare’s hospital claims data: progress has been made, but problems remain. Am J Public Health 1992; 82(2): 243–248. - PMC - PubMed
    1. International Classification of Diseases, Ninth Revision, Clinical Modification. Public Health Service, US Dept of Health and Human: Services Washington, DC, 1988.
    1. Roumie CL, Choma NN, Kaltenbach L, et al. , Non-aspirin NSAIDs, cyclo-oxygenase 2 inhibitors and risk for cardiovascular events-stroke, acute myocardial infarction, and death from coronary heart disease. (submitted to PDS; ). - PubMed

Publication types

Substances