Abstract
Background: Considering a dearth of contemporary data, we aim to compare the demographics, comorbidities, outcomes of acute myocardial infarction (AMI) hospitalizations among young smokers across two national cohorts selected a decade apart. Methods: We utilized National Inpatient Sample (2007 & 2017) to identify AMI in young (18-44 years) tobacco smokers. Demographics, comorbidities, outcomes (all-cause mortality, cardiogenic shock, atrial/ventricular fibrillation/flutter) including hospital resource utilization were assessed. Results: Overall hospitalizations for AMI decreased across a decade among young smokers from 1.7% (23,592/1,355,916) in 2007 to 1.3% (28,775/2,269,124) in 2017. Cohort of 2017 consisted of female (30.8% vs 26.0%), non-white, and Medicaid enrollees (35.1% vs 15.9%), admitted to urban teaching facilities compared to 2007. Young smokers with AMI in 2017 had comorbid hypertension (62.1% vs 48.7%), diabetes (24.3% vs 19.1%), obesity (26.6% vs 15.8%), renal failure (9.6% vs 2.8%), fluid & electrolyte disturbances (24.3% vs 9.5%), congestive heart failure (4.5% vs 1.0%), depression (8.4% vs 6.1%), liver disease (2.5% vs 0.8%) and hyperlipidemia compared to 2007 (p<0.05). Cohort of 2017 showed higher all-cause mortality [2.7% vs 0.9%; OR1.67 (CI 1.39-2.02)], post-MI complications like cardiogenic shock [3.5% vs 1.8%; OR1.40 (CI 1.21-1.62)], atrial fibrillation/flutter [4.6% vs 1.7%; OR2.55 (CI 2.21-2.96)], ventricular fibrillation/flutter [3.3% vs 2.8%; OR1.24 (CI 1.09-1.41)] and lower routine discharges. Despite shortened hospital stay, hospital charges increased in 2017 (p<0.05). Conclusion: Two cohorts of young tobacco smokers with AMI selected a decade-apart showed lower rate of AMI admissions, however, with significantly higher burden of CVD risk factors, all-cause mortality and post-MI complications in 2017 vs 2007.
Published Version
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