Younger Patients Account for Increasing Proportion of AMI
Increase especially great among women, who were less likely to receive guideline-based treatment
TUESDAY, Dec. 4, 2018 (HealthDay News) -- The proportion of hospitalizations for acute myocardial infarction attributable to young patients increased between 1995 and 2014, especially among women, according to a study published online Nov. 11 in Circulation.
Sameer Arora, M.D., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues used data from the Atherosclerosis Risk in Communities surveillance study (1995 to 2014) to assess AMI among young patients (aged 35 to 54 years) in four U.S. communities (Maryland, Minnesota, Mississippi, and North Carolina). Medical records were used to assess medications and procedures.
The researchers found that hospitalizations for AMI in young patients accounted for 30 percent of the 28,732 weighted hospitalizations among 35- to 74-year-olds. For young women, the annual incidence of AMI hospitalizations increased; it decreased for young men. The overall proportion of AMI admissions attributable to young patients increased from 27 percent in 1995-1999 to 32 percent in 2010-2014, with the largest increase seen in young women. Among young AMI patients, the proportion of those with a history of hypertension increased (59 to 73 percent), as did the proportion of those with diabetes mellitus (25 to 35 percent). Young women presenting with AMI were more often black and had a greater comorbidity burden compared with young men. In adjusted analyses, young women had a lower probability of receiving lipid-lowering therapies (relative risk [RR], 0.87), nonaspirin antiplatelets (RR, 0.83), beta blockers (RR, 0.96), coronary angiography (RR, 0.93), and coronary revascularization (RR, 0.79). However, young men and young women had similar one-year all-cause mortality.
"Compared with young men, young women presenting with AMI had a lower likelihood of receiving guideline-based AMI therapies," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.