Abstract 14550: A Decade Trend, Sex, Racial and Socioeconomic Disparities Amongst Patients Hospitalized for Premature Myocardial Infarction in the United States

Abstract

Introduction: Acute myocardial infarction (AMI) is the leading cause of premature morbidity and premature death worldwide. Premature myocardial Infarction (MI) defined as AMI in men < 55 or women < 65 still maintains high incidence compared to the known decrease in AMI in the elderly over the year. Hypothesis: Our study sought to assess the trend of premature MI using a nationally representative sample Methods: This was a trend study of the National Inpatient database (NIS) from 2010 to 2019. We searched for premature MI as the reason for hospitalization using the ICD codes for AMI in females and males less than 65 and 55 respectively. We estimated trends, inpatient mortality, mean length of hospital stay (LOS) and mean total hospital charges (THC) over the studied period. We performed a stratified analysis in categories: sex (male and female), race (Hispanics, Blacks and Caucasians), and median household income for patient's zip code (low-income quartile [LIQ] : 1-$49,999 vs high-income quartile [HIQ]: >$86,000) to assess disparities in outcomes. Multivariable regression analysis adjusted for age and sex was used to obtain trend statistics on outcomes Results: There was a total of 637,173 hospitalizations for premature MI with 58.6% of a them being females. The proportion of females rose by 4.2% in 2010 compared to 2019. Premature MI proportion increased by 43% in Hispanics, 16.4% in Blacks and 4.6% among Caucasians. LIQ had a 8.9% increase in Premature MI while the HIQ had a 10% reduction. There was no significant increase in incidence of premature MI over the time period. Average mortality in female was 2.1% compared to 1.5% in males. Average mortality rate for the time period under study was 1.82% with a 13.7% decrease in mortality over the studied decade. Mortality decreased by 15.2% and 13.6% among females and males respectively. Mortality among Caucasian was 1.72% and decreased by 233.8%, while mortality following premature MI was 1.9% in blacks and decreased by 22.6%. There was trend towards decreasing mean LOS with a 33.2% increase in THC. Conclusions: There appears to be an increased incidence of Premature MI amongst women and LIQ households. Also, among the three studied races, the Hispanic race had the highest rise in the incidence of premature MI.