Abstract 10467: Rising Burden of Cardiovascular Disease Risk and Major Adverse Cardiac Events in Young African American Patients: A National Analysis of Two Cohorts 10-Years Apart (2017 vs. 2007)

Abstract

Background: Previous reports have suggested disparities in healthcare access in the US. We aim to compare the burden of CVD risk factors and major adverse cardiac events (MACE) and in-hospital outcomes among young hospitalized African Americans (18-44 years) selecting two nationally representative samples a decade apart. Methods: Hospitalizations among young (18-44 years) African Americans were identified using The National Inpatient Sample databases in 2007 and 2017. Then, we compared the sociodemographic, comorbidities, and inpatient outcomes including MACE (all-cause mortality, AMI, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, coronary intervention) between 2017 vs. 2007 cohort. Multivariable analyses were performed controlling potential covariates. Results: A total of 2,922,743 (mean age 31 years, 70.3% female) admissions among young African Americans were studied (1,341,068 in 2007 & 1,581,675 in 2017). The 2017 cohort often had younger (mean 30 vs. 31 years), male (30.4% vs. 28.8%) patients with higher non-elective admissions (76.8% vs. 75%) (p<0.001) and showed a rising burden of traditional cardiometabolic comorbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, along with notable reductions in alcohol abuse and drug abuse compared to the 2007 cohort. The adjusted multivariable analysis showed worsening in-hospital outcomes including MACE (aOR 1.21), AMI (aOR1.34), cardiogenic shock (aOR 3.12), Afib/flutter (aOR 1.34), Vfib/flutter (aOR 1.32), cardiac arrest (aOR 2.55), pulmonary embolism (aOR 1.89) and stroke (aOR 1.53). Of note, the 2017 cohort showed a decreased rate of PCI/CABG and all-cause mortality vs. 2007 (p<0.001). Conclusion: Young African American patients have had an increasing burden of CVD risk factors and worsened in-hospital outcomes including MACE and stroke in the last decade, though with improved survival odds.