Abstract 17019: Age-Specific Trends in Acute Myocardial Infarction Hospitalization in Minneapolis/St. Paul

Abstract

Background: Hospitalizations for acute myocardial infarction (AMI) declined during the past 40 years. However, some studies suggest rising rates of AMI in young adults associated with the increasing prevalence of obesity and diabetes, but there are few data in this group. We hypothesized an increase in the rate of AMI hospitalizations among young and middle-aged adults (<50 years) and a decline among older adults. Methods: Data from the Minnesota Hospital Association (MHA) were utilized to identify patients hospitalized with a primary discharge diagnosis of AMI (ICD-9 410) at the 20 acute care hospitals within the Minneapolis-St. Paul metropolitan area (2.85 million) between 1999-2008. Results: From 1999 to 2008, there were 42,850 AMI hospitalizations (4507 in 1999, 3904 in 2008; 13.4% decline) among those aged ≥ 30 years. Among women, the age-standardized rate of AMI hospitalization declined from 239 in 1999 to 169 in 2008, representing an annual proportionate decline of 3.2% (p=0.01) [Table]. Despite the overall decline, the rates of hospitalization among women 30-39 and 40-49 increased during this period (by 1.9% and 2.3%, respectively). In 1999, women aged 30-49 accounted for 5.5% of AMI hospitalizations in all women. By 2008, this age group accounted for 9.2% of hospitalizations. Among men, the age-standardized rate of AMI hospitalizations declined from 506 to 351 during this period (annual proportionate decline of 4.8%, p=0.003). The proportionate decline was lowest among men aged 30-39 (2.7%). Conclusion: In an era of decreasing hospitalization for AMI, differences in trends exist by sex and age. AMI hospitalizations rates increased among young and middle-aged women between 1999 and 2008, potentially due to increased attention paid to heart disease among women, the use of more sensitive biomarkers or actual increase in risk. Despite the aging population, the overall AMI hospitalization case burden decreased by 13% between 1999 and 2008.