Trends in Clinical Characteristics and Outcomes in ST-Elevation Myocardial Infarction Hospitalizations in the United States, 2002-2016

Ahuja, Keerat Rai; Saad, Anas M.; Nazir, Salik; Ariss, Robert W.; Shekhar, Shashank; Isogai, Toshiaki; Kassis, Nicholas; Mahmood, Asif; Sheikh, Mujeeb; Kapadia, Samir

doi:10.1016/j.cpcardiol.2021.101005

Cited by 13 publications

(11 citation statements)

References 28 publications

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“…Over the past decade, there has been a decrease in STEMI‐related mortality in the United States and globally. 44 , 45 , 46 , 47 In another study investigating the national trends in STEMI outcomes, in‐hospital rate mortality decreased from 12.4% in 2002 to 10.5% in 2016, with an annual percentage change of −0.85%, (95% CI, −1.24 to −0.45; P <0.001). 46 Interestingly, in our study, from 2008 to 2019, the adjusted odds ratio for in‐hospital mortality remained unchanged in women and men aged 18 to 55 years.…”

Section: Discussionmentioning

confidence: 99%

“… 7 Additionally, in a meta‐analysis of 68 536 patients with STEMI, the relative risk of in‐hospital mortality was 48% higher in women compared with men. 8 Although there has been a decrease in the incidence of STEMI in the United States, 9 , 10 several studies have suggested that the trends might be stagnant or increasing in young women. 11 , 12 , 13 , 14 , 15 , 16 , 17 A study using data from the Healthcare Cost and Utilization Project from 2001 to 2010 revealed that while there was a decrease in the incidence of acute myocardial infarction hospitalizations in young men, the rates were unchanged or increased in young women.…”

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confidence: 99%

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

Abe

Olanipekun

Adedinsewo

et al. 2023

JAHA

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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.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Abe

Olanipekun

Adedinsewo

et al. 2023

JAHA

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“…According to reports, due to their heightened vulnerability, individuals with ST-segment elevation myocardial infarction (STEMI) in rural areas and lower SES groups require speci c attention [19] . Additionally, a large observational study revealed that those with low SES had a greater frequency of cardiovascular illness [20] .…”

Section: Discussionmentioning

confidence: 99%

“…Another study showed that low SES was linked to a greater incidence of MI in Finland and the United States (hazard ratio (HR) 1.16, 95 percent CI 1.14-1. 19) after controlling for CVD risk factors [6] .…”

Section: Introductionmentioning

confidence: 99%

A Mendelian randomization study investigated the relationship between socioeconomic status and myocardial infarction

Liu

Sun

et al. 2023

Preprint

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Background: It is unclear whether socioeconomic factors causally affect cardiovascular disease risk. Utilizing data from comprehensive genetic associated studies of socioeconomic status (SES) and myocardial infarction (MI), we employed two-sample mendelian randomization (MR) analysis to determine the causality between SES and MI. Method: The genetic summary level data of SES and MI were acquired from various genome-wide association studies (GWAS) studies. We first identified instrumental variables of the socioeconomic determinants and then investigated the causality between instrumental variables and MI. The primary method employed to evaluate this causation was the conventional inverse variance weighted (IVW). Sensitivity analysis was used to assess the underlying heterogeneity and pleiotropy. Results: Age of full-time education has a reverse causal relationship with MI (OR 0.57, 95 percent CI 0.38-0.87, p=0.0096). There is a potential causal association between self-reported household income and the incidence of MI (OR 0.41, 95 percent CI 0.32-0.52, p=8.82×10-14). Additionally, Hard physical work is significantly associated with a higher risk of MI (OR 1.79, 95 percent CI 1.02-3.13, p= 0.042). Conclusions: The idea that low SES levels might raise the incidence of MI is supported by this MR study.

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“…This value conforms to the results of other registries. However, the reported frequencies may vary across studies and strongly depend on the enrolled population and the definitions used [ 2 , 22 , 23 , 24 , 25 , 26 ]. For instance, a recent report from the Polish Registry of Acute Coronary Syndromes (PL-ACS) reported DM in 28.4% of patients with ACS [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus Is Still a Strong Predictor of Periprocedural Outcomes of Primary Percutaneous Coronary Interventions in Patients Presenting with ST-Segment Elevation Myocardial Infarction (from the ORPKI Polish National Registry)

Dziewierz

Zdzierak²,

Malinowski

et al. 2022

JCM

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The impact of diabetes mellitus (DM) on outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) was confirmed by several studies. However, it is unclear whether this effect is still present in large groups of unselected patients undergoing up-to-date treatment. Thus, we sought to assess the impact of DM on periprocedural outcomes of primary PCI in STEMI using data from the Polish National Registry of PCI. Data on 150,782 STEMI patients undergoing primary PCI were collected. Of them, 26,360 (17.5%) patients had DM. Patients with DM were higher-risk individuals who experienced longer reperfusion delays and were less likely to have closed infarct-related artery at baseline (TIMI 0 + 1 flow: 73.2% vs. 72.0%; p < 0.0001) and achieve optimal reperfusion after PCI (TIMI 3 flow: 91.8% vs. 88.5%; p < 0.0001). The periprocedural mortality (1.1% vs. 1.9%; p < 0.0001) was higher in patients with DM and DM was identified as an independent predictor of periprocedural death. In conclusion, despite continuous progress in STEMI treatment, DM remains a strong predictor of periprocedural mortality. However, this detrimental effect of DM may be partially explained by the overall higher risk profile of diabetic patients.

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Trends in Clinical Characteristics and Outcomes in ST-Elevation Myocardial Infarction Hospitalizations in the United States, 2002-2016

Cited by 13 publications

References 28 publications

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

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

A Mendelian randomization study investigated the relationship between socioeconomic status and myocardial infarction

Diabetes Mellitus Is Still a Strong Predictor of Periprocedural Outcomes of Primary Percutaneous Coronary Interventions in Patients Presenting with ST-Segment Elevation Myocardial Infarction (from the ORPKI Polish National Registry)

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