Differences in Baseline Characteristics and Outcomes in Young Caucasians and African Americans with Acute Myocardial
Tariq S Marroush1, Amreeta V Sharma2, Bassent Botros1
1Division of Cardiovascular Disease, Ascension Saint John Hospital, Detroit, MI, United States.
Insights
African American (AA) patients under 50 with acute myocardial infarction (AMI) are more likely to be women with diabetes and hypertension. However, no significant differences were found in outcomes between AA and Caucasian patients.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- The incidence of acute myocardial infarction (AMI) is rising in younger populations.
- Race-related differences in AMI characteristics and outcomes are well-documented in older adults but not in younger individuals.
Purpose of the Study:
- To investigate race-related differences in clinical characteristics, presentation, and outcomes of acute myocardial infarction (AMI) in patients younger than 50 years.
- To compare Caucasian and African American (AA) patients under 50 presenting with AMI.
Main Methods:
- Retrospective chart review of Caucasian and African American (AA) patients under 50 years old who presented with AMI between 2010 and 2017.
- Data collected from an urban community hospital in Detroit, Michigan.
Main Results:
- African American (AA) patients constituted 57.5% of the 271 identified patients.
- AA patients were more likely to be women and have a history of diabetes, hypertension, and higher BMI (>30 kg/m²).
- While presentation features differed (e.g., non-ST-elevation MI more common in AAs), angiographic findings and in-hospital outcomes were similar, with lower need for mechanical support in AAs.
Conclusions:
- This study highlights previously undescribed race-related differences in the history, presentation, and clinical features of AMI in young African American (AA) versus Caucasian patients.
- Findings suggest potential implications for developing tailored preventive strategies to reduce AMI incidence and adverse events in both racial groups.
Background:
The incidence of acute myocardial infarction (AMI) in young patients is increasing. While race-related differences in clinical characteristics and outcomes for older AMI patients have been well-studied, such differences in young patients are unknown.
Methods:
We performed a retrospective review of charts of Caucasian and African American (AA) patients <50 years of age, presenting with AMI between 2010 and 2017 in an urban, community hospital in Detroit, Michigan.
Results:
A total of 271 patients were identified with 156 being AAs (57.5%). Mean age was 43 years which was similar in both groups. AAs with AMI were 2.2 times more likely to be women and to have a history of diabetes and 1.2 times more likely to have BMI >30 kg/m2. History of coronary artery disease (1.8-fold) and hypertension (1.5-fold) were also more common in AAs. Overall presenting features were similar, other than that AAs presented more often with non-ST-elevation MI and tended to present less often with cardiac arrest. No differences were observed in the angiographic findings or in-hospital outcomes in the two groups, with the exception of lower need of mechanical support in AAs.
Conclusions:
In conclusion, our data provide important, not previously described information on race-related differences in history, presentation, clinical and angiographic features and outcomes in AAs compared with Caucasians younger than 50 with AMI. These findings may have implications for tailoring specific preventive strategies to decrease the incidence of AMI and its associated adverse events in both racial groups.
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