Abstract 12218: Nationwide Trends in Subsequent Myocardial Infarction Hospitalizations and Mortality in Elderly Patients With Prior Myocardial Infarction and Associated Racial/Socioeconomic Disparities: A National Inpatient Sample Analysis

Abstract

Background: There is a scarcity of large-scale data on race, sex, and economic status-based disparities in trends of subsequent/recurrent myocardial infarction (MI) in elderly individuals who have had a previous MI. Methods: National Inpatient Sample databases (2016-2019, ICD10 codes) were queried to identify elderly (≥65 years) patients with prior MI and divided into having and not having subsequent MI admissions. Primary outcomes were nationwide trends in subsequent MI admissions and all-cause in-hospital mortality in these patients with racial, sex, and economic status disparities. Results: A total of 421,960 recurrent MI admissions were identified [61.1% male, 38.9% female, 80.7% white and median age 76yrs (p<0.001)]. Between 2016 and 2019, both males and females experienced an increase in recurrent MI from 9.1 to 10.6% and 8.1 to 9.8%, respectively, but a reassuring decrease in in-hospital mortality from 7.75 to 6.4% and 7.8 to 6.6% (P trends <0.001). All race groups demonstrated a rise in recurrent MI, with blacks experiencing the largest increase from 9.2 to 11.7%(P trend <0.001). In-hospital mortality for recurrent MI declined in all races except blacks and Native Americans (P trends >0.05), with Asian/Pacific Islanders experiencing the highest decline from 13 to 7.4%(P trends <0.001). All income quartile groups had an increase in recurrent MI with a more prominent increase in the lowermost income quartile cohort (P trends <0.001). There was an overall trend of decreasing in-hospital mortality except for the lowermost income quartile which did not show improving trends in mortality (P trend =0.079). Conclusions: Elderly patients with a history of MI had an upward tendency for recurrent MI hospitalizations but a downward trend for all-cause in-hospital mortality with prevailing racial and socioeconomic disparities. Blacks and lower income quartile patients with CVD risk may need focused post-MI care to curtail subsequent MI and mortality risk.