Abstract 14459: Ten Year Evolving Profile of Black Americans With Myocardial Infarctions

Abstract

Background: Racial disparities in the management and outcomes of myocardial infarction have been widely reported. Overall, the rate of cardiovascular (CV) death has risen since 2010 while hospitalization rates remain flat. Here, we provide a comprehensive analysis, using a large database, of the evolving profile of Black Americans (BA) who suffered myocardial infarctions (MI) over the past 10 years and compared BA to the non-Black (non-BA) population. We also describe the change in their characteristics between 2 continuous 5-year periods (2010-14, 2015- 19) with the goal of identifying opportunities for care improvement. Methods: We used the OptumLabs Data Warehouse EHR data. Acute MI cases were based on discharge diagnosis codes for adults > 35 years of age between 1/1/2010 and 12/31/2019. A single individual could have had multiple MI’s. Data were analyzed descriptively. Results: A total of 36M annual observations were analyzed which included 129,146 MI’s with complete EHR data. MI’s among BA patients comprised 8.7% of the total in the 1 st period and went up to 10.4% in the 2 nd period.The main characteristics between BA and non-BA cases and between periods are shown in the table. In general, BA MI patients were younger than non-BA (57% vs 40% were <65). Conclusion: Compared to non-Blacks, Black patients with myocardial infarctions over the past 10 years exhibit a profile characterized by: MI’s at a younger age, almost half female, more DM, higher cholesterol and blood pressure levels, higher rate of smoking, more are Medicaid and ¾ live in the South.When comparing only Black patients between 2010-14 and 2015-2019 there was a marked increase in total MI’s, mostly in the 55-75 age range, increased diabetes, smoking and rising SBP levels.The description of an evolving profile among Blacks with MI’s could, at least partly, explain the rising trend of CV mortality, identify potential gaps in care and the need to design new forms to detect subclinical atherosclerosis.