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Multicenter Study
. 2014 Jul 29;64(4):337-45.
doi: 10.1016/j.jacc.2014.04.054.

Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010

Aakriti Gupta  1 , Yongfei Wang  2 , John A Spertus  3 , Mary Geda  4 , Nancy Lorenze  4 , Chileshe Nkonde-Price  5 , Gail D'Onofrio  6 , Judith H Lichtman  7 , Harlan M Krumholz  8
Affiliations
Multicenter Study

Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010

Aakriti Gupta et al. J Am Coll Cardiol. .

Abstract

Background: Various national campaigns launched in recent years have focused on young women with acute myocardial infarctions (AMIs). Contemporary longitudinal data about sex differences in clinical characteristics, hospitalization rates, length of stay (LOS), and mortality have not been examined.

Objectives: This study sought to determine sex differences in clinical characteristics, hospitalization rates, LOS, and in-hospital mortality by age group and race among young patients with AMIs using a large national dataset of U.S. hospital discharges.

Methods: Using the National Inpatient Sample, clinical characteristics, AMI hospitalization rates, LOS, and in-hospital mortality were compared for patients with AMI across ages 30 to 54 years, dividing them into 5-year subgroups from 2001 to 2010, using survey data analysis techniques.

Results: A total of 230,684 hospitalizations were identified with principal discharge diagnoses of AMI in 30- to 54-year-old patients from Nationwide Inpatient Sample data, representing an estimated 1,129,949 hospitalizations in the United States from 2001 to 2010. No statistically significant declines in AMI hospitalization rates were observed in the age groups <55 years or stratified by sex. Prevalence of comorbidities was higher in women and increased among both sexes through the study period. Women had longer LOS and higher in-hospital mortality than men across all age groups. However, observed in-hospital mortality declined significantly for women from 2001 to 2010 (from 3.3% to 2.3%, relative change 30.5%; p for trend < 0.0001) but not for men (from 2% to 1.8%, relative change 8.6%; p for trend = 0.60).

Conclusions: AMI hospitalization rates for young people have not declined over the past decade. Young women with AMIs have more comorbidity, longer LOS, and higher in-hospital mortality than young men, although their mortality rates are decreasing.

Keywords: acute myocardial infarction; hospitalization; sex differences; trends; young women.

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Figures

Figure 1
Figure 1. Trends in Selected Comorbidities among Young Patients with AMI, 2001–2010
Trends in selected comorbidities including hypertension, diabetes, heart failure, renal failure, and stroke are shown for black women, white women, black men and white men respectively with AMI from 2001–2010. Black women had the highest prevalence of hypertension, diabetes, and heart failure across all groups. The prevalence of hypertension and diabetes increased significantly for all subgroups from 2001–2010.
Figure 2
Figure 2. AMI Hospitalization Rates by Race and Sex among Young Patients with AMI, 2001–2010
Trends in hospitalizations rates for persons aged 30–54 years with AMI are shown by race and sex across 5-year subgroups of age. Of note, black women had much higher hospitalization rates than white women consistently from 2001–2010, while hospitalization rates were comparable for black and white men.
Figure 3
Figure 3. Central Illustration: Acute MI Trends in Young Women and Men, 2001–2010
(A) Overall comparisons of comorbidities, hospitalization rates, and short term outcomes in young women with AMI as compared to young men (B) Trends in young women and men with AMI, 2001–2010
See this image and copyright information in PMC

Comment in

References

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