Author + information
- Received August 27, 2013
- Revision received March 29, 2014
- Accepted April 30, 2014
- Published online July 29, 2014.
- Aakriti Gupta, MBBS∗,†,
- Yongfei Wang, MS∗,‡,
- John A. Spertus, MD, MPH§,‖,
- Mary Geda, MSN∗,
- Nancy Lorenze, DNSc, MSN∗,
- Chileshe Nkonde-Price, MD‡,¶,#,
- Gail D'Onofrio, MD, MS∗∗,
- Judith H. Lichtman, PhD, MPH∗,†† and
- Harlan M. Krumholz, MD, SM∗,‡,‡‡,§§∗ ()
- ∗Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
- †Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- ‡Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- §St. Luke's Mid America Heart Institute, Kansas City, Missouri
- ‖University of Missouri–Kansas City, Kansas City, Missouri
- ¶VA Center for Health Equity and Research Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania
- #Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- ∗∗Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut
- ††Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
- ‡‡Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut
- §§Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
- ↵∗Reprint requests and correspondence:
Dr. Harlan M. Krumholz, Department of Internal Medicine, Yale University School of Medicine, 1 Church Street, Suite 200, New Haven, Connecticut 06510.
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.
This work was supported by grant U01 HL105270-04 (Center for Cardiovascular Outcomes Research at Yale University) and grant R01 LH081153-06 (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), both from the National Heart, Lung, and Blood Institutehttp://dx.doi.org/10.13039/100000050. Dr. Spertus has received research grants from Genentech and Eli Lilly and Company. Dr. Krumholz has a research agreement to share data with Johnson & Johnson; and is chair of a scientific advisory board of UnitedHealthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 27, 2013.
- Revision received March 29, 2014.
- Accepted April 30, 2014.
- American College of Cardiology Foundation