Trends In ST-elevation Myocardial Infarction Hospitalisation Among Young Adults: A Binational Analysis

Moledina, Saadiq M; Matetic, Andrija; Weight, Nicholas; Rashid, Muhammad; Sun, Louise; Fischman, David L; Van Spall, Harriette G C; Mamas, Mamas A

Abstract

Background ST-segment myocardial infarction (STEMI) is typically associated with increased age, but there is an important group of patients that suffer STEMI under the age of fifty, that are not well characterized in studies. Methods & Results We analysed results from Myocardial Ischemia National Audit Project (MINAP) from the United Kingdom (UK) between 2010-2017 and the National Inpatient Sample (NIS) from the United States (US) between 2010-2018. After exclusion criteria, there were 32,719 STEMI patients aged ≤50 from MINAP, and 238,952 patients’ ≤50 from the NIS. We analysed temporal trends in demographics, management, and mortality. The proportion of females increased, 15.6% (2010-2012) to 17.6% (2016-2017) (UK) and 22.8% (2010-2012) to 23.1% (2016-2018) (US). The proportion of white patients decreased, from 86.7% (2010) to 79.1% (2017) (UK) and 72.1% (2010) to 67.1% (2017) (US). Invasive coronary angiography (ICA) rates increased in UK (2010-2012: 89.0%, 2016-2017: 94.3%), while decreased in US (2010-2012: 88.9%, 2016-2018: 86.2% (US). After adjusting for baseline characteristics and management strategies, there was no difference in all-cause mortality in the UK in 2016-2017 compared to 2010-2012 (OR:1.21, 95% CI:0.60-2.40), but there was a decrease in the US in 2016-2018 compared to 2010-2012 (OR: 0.84, 95% CI: 0.79-0.90). Conclusion The demographics of young STEMI patients have temporally changed in the UK and US, with increased proportions of females and ethnic minorities. There was a significant increase in the frequency of diabetes mellitus over the respective time periods in both countries.

Citation

Moledina, S. M., Matetic, A., Weight, N., Rashid, M., Sun, L., Fischman, D. L., …Mamas, M. A. (in press). Trends In ST-elevation Myocardial Infarction Hospitalisation Among Young Adults: A Binational Analysis. European Heart Journal - Quality of Care and Clinical Outcomes, https://doi.org/10.1093/ehjqcco/qcad035

• Journal Article Type: Article
• Acceptance Date: Jun 13, 2023
• Online Publication Date: Jun 13, 2023
• Deposit Date: Jun 29, 2023
• Publicly Available Date: Jun 14, 2024
• Journal: European Heart Journal - Quality of Care and Clinical Outcomes
• Print ISSN: 2058-5225
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1093/ehjqcco/qcad035
• Keywords: Cardiology and Cardiovascular Medicine, Health Policy