Trends in ST-elevation myocardial infarction hospitalization among young adults: a binational analysis
Saadiq M Moledina1, Andrija Matetic1, Nicholas Weight1
1Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, Staffordshire, ST5 5BG, UK.
Insights
Young patients experiencing ST-segment myocardial infarction (STEMI) show evolving demographics, with more females and minorities. Management and outcomes varied between the UK and USA, highlighting differing trends in this patient group.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- ST-segment myocardial infarction (STEMI) typically affects older individuals.
- A significant, yet understudied, population experiences STEMI before age 50.
- Characterizing this demographic is crucial for understanding disease trends.
Purpose of the Study:
- To analyze temporal trends in demographics, management, and mortality of STEMI patients under 50 in the UK and USA.
- To identify changes in the characteristics of young STEMI patients over time.
Main Methods:
- Utilized data from the Myocardial Ischemia National Audit Project (MINAP) in the UK (2010-2017) and the National Inpatient Sample (NIS) in the USA (2010-2018).
- Included 32,719 UK and 238,952 USA STEMI patients aged ≤50.
- Analyzed demographic shifts, invasive coronary angiography (ICA) rates, and all-cause mortality.
Main Results:
- The proportion of females and ethnic minorities among young STEMI patients increased in both countries.
- Invasive coronary angiography (ICA) rates rose in the UK but declined in the USA.
- All-cause mortality showed no significant change in the UK but decreased in the USA.
Conclusions:
- Demographics of young STEMI patients have shifted towards higher proportions of females and ethnic minorities.
- Diabetes mellitus frequency significantly increased in this population in both the UK and USA.
- Temporal trends in management and outcomes for young STEMI patients differ between the UK and USA.
Background:
ST-segment myocardial infarction (STEMI) is typically associated with increased age, but there is an important group of patients who suffer from STEMI under the age of 50 who are not well characterized in studies.
Methods And Results:
We analysed results from Myocardial Ischemia National Audit Project (MINAP) from the United Kingdom (UK) between 2010 and 2017 and the National Inpatient Sample (NIS) from the United States of America (USA) between 2010 and 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) (USA). The proportion of white patients decreased, from 86.7% (2010) to 79.1% (2017) (UK) and 72.1% (2010) to 67.1% (2017) (USA). Invasive coronary angiography (ICA) rates increased in UK (2010-2012: 89.0%, 2016-2017: 94.3%), while decreased in USA (2010-2012: 88.9%, 2016-2018: 86.2% (USA). 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 USA 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 USA, 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.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:14Myocarditis III: Medical Management
01:28Acute Coronary Syndrome IV: Interprofessional Care