Twenty Year Trends and Sex Differences in Young Adults Hospitalized With Acute Myocardial Infarction.

TitleTwenty Year Trends and Sex Differences in Young Adults Hospitalized With Acute Myocardial Infarction.
Publication TypeJournal Article
Year of Publication2019
AuthorsArora S, Stouffer GA, Kucharska-Newton AM, Qamar A, Vaduganathan M, Pandey A, Porterfield D, Blankstein R, Rosamond WD, Bhatt DL, Caughey MC
JournalCirculation
Volume139
Issue8
Pagination1047-1056
Date Published2019 02 19
ISSN1524-4539
KeywordsAdult, Age Distribution, Age Factors, Aged, Female, Health Status Disparities, Healthcare Disparities, Hospitalization, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Risk Assessment, Risk Factors, Sex Distribution, Sex Factors, Time Factors, United States
Abstract

BACKGROUND: Sex differences are known to exist in the management of older patients presenting with acute myocardial infarction (AMI). Few studies have examined the incidence and risk factors of AMI among young patients, or whether clinical management differs by sex.

METHODS: The Atherosclerosis Risk in Communities (ARIC) Surveillance study conducts hospital surveillance of AMI in 4 US communities (MD, MN, MS, and NC). AMI was classified by physician review, using a validated algorithm. Medications and procedures were abstracted from the medical record. Our study population was limited to young patients aged 35 to 54 years.

RESULTS: From 1995 to 2014, 28 732 weighted hospitalizations for AMI were sampled among patients aged 35 to 74 years. Of these, 8737 (30%) were young. The annual incidence of AMI hospitalizations increased for young women but decreased for young men. The overall proportion of AMI admissions attributable to young patients steadily increased, from 27% in 1995 to 1999 to 32% in 2010 to 2014 ( P for trend=0.002), with the largest increase observed in young women. History of hypertension (59% to 73%, P for trend

CONCLUSIONS: The proportion of AMI hospitalizations attributable to young patients increased from 1995 to 2014 and was especially pronounced among women. History of hypertension and diabetes among young patients admitted with AMI increased over time as well. Compared with young men, young women presenting with AMI had a lower likelihood of receiving guideline-based AMI therapies. A better understanding of factors underlying these changes is needed to improve care of young patients with AMI.

DOI10.1161/CIRCULATIONAHA.118.037137
Alternate JournalCirculation
PubMed ID30586725
PubMed Central IDPMC6380926
Grant ListHHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
UL1 TR001102 / TR / NCATS NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States