Abstract 8398: Trends in Clinical and Demographic Features of Patients with Acute Myocardial Infarction in the First Decade of the 21st Century. A Report from the American Heart Association Get-With-The-Guidelines Coronary Artery Disease Program

Abstract

Introduction Decreases in incidence of acute myocardial infarction (AMI) in the U.S. have been observed over the last 40 years, in part due to beneficial changes in risk factors. The composition of the U.S. population from 2000-2010 has changed and it remains unknown whether the clinical (CLIN) and demographic (DEMO) features of patients with AMI may also have changed. Methods We reviewed data collected from 136,238 patients with AMI admitted from 2003-2008 to hospitals participating in the American Heart Association - Get With The Guidelines Coronary Artery Disease program. The dataset was analyzed in total and stratified by type of AMI (STEMI or NSTEMI). CLIN and DEMO characteristics were assessed for each year and the odds of change in prevalence of each characteristic with time (per 1 year increase) was analyzed with univariable and multivariable logistic regression. Results Overall, the prevalence of obesity (30.4%) and the proportion of patients with HDL < 40 mg/dl (39.8%) increased while the prevalence of hypertension remained stable but high (68%). The proportion of patients with LDL > 100 mg/dL (32.8%) decreased over time. There was a significant increase over time in the proportion of patients with NSTEMI. Racial distribution of patients also varied significantly over time. Differences in DEMO and CLIN factors within and between AMI strata varied from the observations in the combined patient sample. Conclusions We observed, overall, a decreasing prevalence of younger individuals and an increasing prevalence of obesity and low HDL, findings which represent continuation of a pattern observed at the end of the 20th century. Stratum-specific differences in the prevalence of key risk factors warrant caution considering AMI a uniform entity. In light of changes in the DEMO composition of the US population from 2000-2010, these trends have important implications for projections of disease burden and targeting prevention efforts.