Trends and Outcomes of ST‐Segment–Elevation Myocardial Infarction Among Young Women in the United States

Abstract

Background Although there has been a decrease in the incidence of ST‐segment–elevation myocardial infarction (STEMI) in the United States, this trend might be stagnant or increasing in young women. We assessed the trends, characteristics, and outcomes of STEMI in women aged 18 to 55 years. Methods and Results We identified 177 602 women aged 18 to 55 with the primary diagnosis of STEMI from the National Inpatient Sample during years 2008 to 2019. We performed trend analyses to assess hospitalization rates, cardiovascular disease (CVD) risk factor profile, and in‐hospital outcomes stratified by three age subgroups (18–34, 35–44, and 45–55 years). We found STEMI hospitalization rates were decreased in the overall study cohort from 52 per 100 000 hospitalizations in 2008 to 36 per 100 000 in 2019. This was driven by decreased proportion of hospitalizations in women aged 45 to 55 years (74.2% to–71.7%; P <0.001). Proportion of STEMI hospitalizationincreased in women aged 18–34 (4.7%–5.5%; P <0.001) and 35–44 years (21.2%–22.7%; P <0.001). The prevalence of traditional and non‐traditional female‐specific or female‐predominant CVD risk factors increased in all age subgroups. The adjusted odds of in‐hospital mortality in the overall study cohort and age subgroups were unchanged throughout the study period. Additionally, we observed an increase in the adjusted odds of cardiogenic shock, acute stroke, and acute kidney injury in the overall cohort over the study period. Conclusions STEMI hospitalizations are increasing among women aged <45 years, and in‐hospital mortality has not changed over the past 12 years in women aged <55 years. Future studies on the optimization of risk assessment and management of STEMI in young women are urgently needed.

A Case of Acute ST-Segment Elevation Myocardial Infarction as an Initial Presentation of Essential Thrombocythemia in a Young Healthy Male

“…This combination was deemed appropriate given his classification as high risk for thrombotic complications. Hydroxyurea is considered the first-line drug for cytoreductive therapy in ET [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Its inclusion in the treatment regimen aims to reduce the risk of thrombotic events associated with ET while managing platelet count and minimizing the potential for hemorrhagic complications.…”

Multifaceted Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on ST-Elevation Myocardial Infarction (STEMI): A Literature Review of Incidence, Treatment Modalities, and Outcomes

“…Primarily, risk factors for STEMI include dyslipidemia, diabetes, hypertension, smoking, and a family history of coronary artery disease [ 8 ]. Globally, over three million people every year present with STEMI, while in the United States, it affects approximately 750,000 people each year posing a significant health burden [ 9 , 10 ]. The possible pathophysiology of varied expressions of STEMI during the COVID-19 pandemic can be explained by the following mechanisms.…”

Bivalirudin versus heparin in STEMI after BRIGHT-4 trial: an updated meta-analysis

“…ST-segment elevation myocardial infarction (STEMI) remains a major healthcare burden globally [1,2] as well as in the USA [3]. In the USA, STEMI results in ≈750 000 cases annually and has a higher burden in the older population and women [3].…”

“…ST-segment elevation myocardial infarction (STEMI) remains a major healthcare burden globally [1,2] as well as in the USA [3]. In the USA, STEMI results in ≈750 000 cases annually and has a higher burden in the older population and women [3]. Reperfusion therapy, preferably by primary percutaneous intervention (PPCI) is recommended therapy for STEMI by the American Heart Association/American College of Cardiology (AHA/ACC) [4] as well as the European Society of Cardiology (ESC) [2] if it can be performed in a timely fashion within 12 h of onset of STEMI.…”