Abstract P076: Genetic Factors Modify the Triggering of Acute Myocardial Infarction by Transient Exposure to Coffee Intake

Introduction: Caffeinated coffee increases sympathetic nervous activity that may adversely affect a vulnerable atherosclerotic plaque and therefore trigger an acute myocardial infarction (AMI). Additionally, it is possible that genetic variation alter the susceptibility to the acute effects of coffee. Hypothesis: We assessed the hypothesis that genetic factors associated to AMI can modify the triggering of AMI by acute coffee intake. Methods: We collected information on intake of coffee during the 24 hours and days before the myocardial infarction and habitual intake of coffee in 1,234 incident cases of non-fatal AMI from 1994–2004. Data was analyzed as a case-crossover design assuming a hazard period of 1 hour. We used a genetic score with 3 loci from AMI GWAS that has been validated in this population. People with a higher score have a greater risk for AMI. In addition, we also evaluated one polymorphism in the cytochrome P450 1A2 candidate gene that decreases the enzyme inducibility, resulting in impaired caffeine metabolism. Carriers of the variant CYP1A2*1F allele are slow caffeine metabolizers, whereas individuals who are homozygous for the CYP1A2*1A allele are rapid metabolizers. Results: Participants were classified as low AMI genetic risk (1 to 3 alleles) or high genetic risk (4 to 6 alleles) according to the genetic risk score. RR for the association between coffee and AMI were 1.72 (95%CI:1.22, 2.43) and 1.06 (95%CI:0.85, 1.31) for the low and high genetic risk groups respectively (test of homogeneity p-value=0.02). RR were 1.38 (95%CI:1.07, 1.76) and 0.99 (95%CI:0.77, 1.28) for homozygous carriers of the rapid CYP1A2*1A allele and carriers of the slow CYP1A2*1F allele, respectively (test of homogeneity p-value =0.067). Because we have shown previously that coffee intake is not associated with AMI among heavy drinkers (≥ 4 cups/d), we repeated the analysis among light/occasional and moderate drinkers. RR were 1.69 (95%CI:1.28, 2.23) and 1.09 (95%CI:0.80, 1.48) for rapid and slow metabolizers, respectively (test of homogeneity p-value=0.038). Conclusions: In conclusion, people with lower genetic risk seem to be more susceptible to coffee. It is possible that the effect of environmental factors (including triggers like coffee intake) is higher among people who are not at risk because of genetic factors. Light and moderate drinkers who are rapid caffeine metabolizers are also more susceptible to coffee. It is possible that light/moderate drinkers who are slow metabolizers develop more tolerance to caffeine than rapid metabolizers.

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P1551A genetic risk score predicts recurrent events after myocardial infarction in young adults

European Heart Journal ◽

10.1093/eurheartj/ehz748.0311 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L M Rincon ◽

M Sanmartin ◽

G L Alonso ◽

J A Rodriguez ◽

A Muriel ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Risk Score ◽

Genetic Risk ◽

Recurrent Events ◽

Cardiac Ct ◽

Ldl Cholesterol ◽

Genetic Risk Score ◽

P Value ◽

Diabetic Patients

Abstract Background To evaluate whether a genetic risk score (GRS) improves the prediction of recurrent events in young non-diabetic patients presenting with an acute myocardial infarction and identifies a more aggressive form of atherosclerosis in this population. Methods and results We performed a prospective study including 81 consecutive non-diabetic patients aged below 55 y.o. presenting with an acute myocardial infarction (48±6 y.o., 89% male). A comprehensive study including serum biomarkers, genetic testing and cardiac CT was performed. We studied the association of a GRS composed of 11 genetic variants with a primary composite end-point (all-cause mortality, recurrent acute coronary syndrome, and cardiac re-hospitalisation). After a median follow-up of 4.1 (3.5 - 4.4) years 24 recurrent events were documented. A significantly higher prevalence of 9 out of 11 risk alleles was noted compared with general population. The GRS was significantly associated with recurrent events, especially when baseline LDL-cholesterol levels were elevated. Compared with the low-risk GRS category, the multivariate-adjusted hazard ratio for recurrent events for the intermediate-risk GRS category was 10.2 (95% CI 1.1–100.3, p=0.04) and for the high-risk GRS was 20.7 (2.4–181.0, p=0.006) when LDL-C ≥2.8 mmol/L. Inclusion of the GRS improved the C statistic (ΔC statistic =0.086), the continuous Net Reclassification Index (30%) and the Integrated Discrimination Improvement (0.05) compared with a multivariate clinical risk model. Cardiac CT detected coronary calcified atherosclerosis and numerous plaques but it had a limited value for prediction of recurrences. No association was observed between extracellular matrix metabolism biomarkers and GRS or recurrent events in this population. Cox regression analysis between GRS terciles and LDL-C Univariate analysis Multivariate analysis* HR (95% CI) p-value HR (95% CI) p-value* Low GRS 1 1 Intermediate GRS 2.0 (0.7–5.8) 0.21 LDL-C≤110 mg/dL (≤2.8 mmol/L) 1.0 (0.3–4.0) >110 mg/dL (>2.8 mmol/L) 10.2 (1.1–100.3) 0.04 High GRS 3.0 (1.0–9.2) 0.05 LDL-C≤110 mg/dL (≤2.8 mmol/L) 0.3 (0.1–1.9) >110 mg/dL (>2.8 mmol/L) 20.7 (2.4–181.0) 0.006 *Multivariate model adjusted for GRACE risk score and LDL-C and interaction. There was a strong interaction between GRS terciles and LDL-C (p<0.01). Recurrent events based on genetic risk Conclusions A multilocus genetic risk score identified non-diabetic young patients at increased risk for recurrent events after a myocardial infarction. The significance of LDL-cholesterol in relation to genetic predisposition for recurrences merits further evaluation. Acknowledgement/Funding Instituto de Salud Carlos III (PI12/0564, PI14/01152 and PI15/00667), the CIBERCV and the Spanish Society of Cardiology (2015/CC)

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OP0234 RISK OF ACUTE MYOCARDIAL INFARCTION AMONG NEW USERS OF CHONDROITIN SULPHATE: A NESTED CASE-CONTROL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.123 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 144.1-144

Author(s):

R. Mazzucchelli ◽

S. Rodriguez-Martin ◽

A. García-Vadillo ◽

M. Gil ◽

A. Rodríguez-Miguel ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Acute Myocardial Infarction ◽

Cardiovascular Risk ◽

Case Control Study ◽

Chondroitin Sulphate ◽

Case Control ◽

Nested Case Control ◽

Incident Cases ◽

Control Study

Background:There is some evidence from epidemiological studies suggesting that CS and glucosamine could play a role in cardiovascular disease (CVD) prevention (1-4).Studies to date have included prevalent users, therefore a bias that overestimates protection cannot be excluded.Objectives:To test the hypothesis that chondroitin sulphate (CS) or glucosamine reduce the risk of acute myocardial infarction (AMI).Methods:Case-control study nested in a primary cohort composed of patients aged 40 to 99 years, with at least one year of follow-up in the BIFAP database during the 2002-2015 study period. From this cohort of patients, we identified incident cases of AMI and randomly selected five controls per case, matched by exact age, gender, and index date. Adjusted odds ratios (AOR) and their corresponding 95% confidence interval (CI)) were calculated through a conditional logistic regression. Only new users of CS or glucosamine were considered.Results:A total of 23,585 incident cases of AMI and 117,405 controls were included. The mean age was 67.0 (SD 13.4) years and 71.75% were male, in both groups. 558 (2.37%) cases and 3,082 (2.62%) controls used or had used CS. The current use of CS was associated with a lower risk of AMI (AOR 0.57; 95%CI: 0.46–0.72) and disappeared after discontinuation (recent and past users). The reduced risk among current users was observed in both short-term (<365 days AOR 0.58; 95%CI: 0.45-0.75) and long-term users (>364 days AOR 0.56; 95%CI 0.36-0.87), in both sexes (men, AOR=0.52; 95%CI:0.38-0.70; women, AOR=0.65; 95%CI: 0.46-0.91), in individuals over or under 70 years of age (AOR=0.54; 95%CI:0.38-0.77, and AOR=0.61; 95%CI:0.45-0.82, respectively) and in individuals at intermediate (AOR=0.65; 95%CI:0.48-0.91) and high cardiovascular risk (AOR=0.48;95%CI:0.27-0.83), but not in those at low risk (AOR=1.11; 95%CI:0.48-2.56). In contrast, the current use of glucosamine was not associated with either increased or decreased risk of AMI (AOR= 0.86; CI95% 0.66-1.08)Conclusion:Our results support a cardioprotective effect of CS, while no effect was observed with glucosamine. The highest protection was found among subgroups at higher cardiovascular risk.References:[1]Ma H, Li X, Sun D, Zhou T, Ley SH, Gustat J, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019;365(Journal Article):l1628.[2]de Abajo FJ, Gil MJ, Garcia Poza P, Bryant V, Oliva B, Timoner J, et al. Risk of nonfatal acute myocardial infarction associated with non-steroidal antiinflammatory drugs, non-narcotic analgesics and other drugs used in osteoarthritis: a nested case-control study. PharmacoepidemiolDrug Saf. 2014;23(11):1128–38.[3]Li Z-H, Gao X, Chung VC, Zhong W-F, Fu Q, Lv Y-B, et al. Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study. Ann Rheum Dis. 2020 Apr 6;annrheumdis-2020-217176.[4]King DE, Xiang J. Glucosamine/Chondroitin and Mortality in a US NHANES Cohort. J Am Board Fam Med. 2020 Dec;33(6):842–7.Disclosure of Interests:Ramón Mazzucchelli Speakers bureau: UCB, Lilly, Grant/research support from: Pfizer, Roche, Amgen, Sara Rodriguez-Martin: None declared, Alberto García-Vadillo: None declared, Miguel Gil: None declared, Antonio Rodríguez-Miguel: None declared, Diana Barreira-Hernández: None declared, Alberto García-Lledó: None declared, Francisco de Abajo: None declared

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Mortality of major cardiovascular emergencies among patients admitted to hospitals on weekends as compared with weekdays in Taiwan

BMC Health Services Research ◽

10.1186/s12913-021-06553-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chao-Lun Lai ◽

Raymond Nien-Chen Kuo ◽

Ting-Chuan Wang ◽

K. Arnold Chan

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Pulmonary Embolism ◽

Ischemic Stroke ◽

Aortic Aneurysm ◽

Hospital Mortality ◽

Weekend Effect ◽

Claims Database ◽

Ruptured Aortic Aneurysm ◽

Incident Cases

Abstract Background Several studies have found a so-called weekend effect that patients admitted at the weekends had worse clinical outcomes than patients admitted at the weekdays. We performed this retrospective cohort study to explore the weekend effect in four major cardiovascular emergencies in Taiwan. Methods The Taiwan National Health Insurance (NHI) claims database between 2005 and 2015 was used. We extracted 3811 incident cases of ruptured aortic aneurysm, 184,769 incident cases of acute myocardial infarction, 492,127 incident cases of ischemic stroke, and 15,033 incident cases of pulmonary embolism from 9,529,049 patients having at least one record of hospitalization in the NHI claims database within 2006 ~ 2014. Patients were classified as weekends or weekdays admission groups. Dates of in-hospital mortality and one-year mortality were obtained from the Taiwan National Death Registry. Results We found no difference in in-hospital mortality between weekend group and weekday group in patients with ruptured aortic aneurysm (45.4% vs 45.3%, adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.87–1.17, p = 0.93), patients with acute myocardial infarction (15.8% vs 16.2%, adjusted OR 0.98, 95% CI 0.95–1.00, p = 0.10), patients with ischemic stroke (4.1% vs 4.2%, adjusted OR 0.99, 95% CI 0.96–1.03, p = 0.71), and patients with pulmonary embolism (14.6% vs 14.6%, adjusted OR 1.02, 95% CI 0.92–1.15, p = 0.66). The results remained for 1 year in all the four major cardiovascular emergencies. Conclusions We found no difference in either short-term or long-term mortality between patients admitted on weekends and patients admitted on weekdays in four major cardiovascular emergencies in Taiwan.

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Association of Stress hyperglycemia and adverse cardiac events in acute myocardial infarction – A cohort study

Cardiovascular & Haematological Disorders - Drug Targets ◽

10.2174/1871529x22666211221152546 ◽

2021 ◽

Vol 22 ◽

Author(s):

Annu Rajpurohit ◽

Bharat Sejoo ◽

Rajendra Bhati ◽

Prakash Keswani ◽

Shrikant Sharma ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Blood Glucose ◽

Clinical Outcomes ◽

P Value ◽

Cardiac Events ◽

Stress Hyperglycemia ◽

Adverse Cardiac Events ◽

Hba1c Levels

Background: Stress hyperglycemia is a common phenomenon in patients presenting with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia at the time of hospital presentation and adverse cardiac events in myocardial infarction during the course of hospital stay. Methods: Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%). Results: Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value = 0.609 and mortality 16.7% vs. 17.3%, p value = 0.856). Conclusions: Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be vigilant for admission blood glucose while treating MI patients.

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Gender-Related Differences of Cardiac Troponin-I Levels in Patients with Acute Myocardial Infarction at Time of Acute Chest Pain

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i52a33576 ◽

2021 ◽

pp. 199-205

Author(s):

Mahir Abdulkadhum Khudhair Alzughaibi ◽

Ammar Waheeb Obeiad ◽

Nassar Abdalaema Abdalhadi Mera ◽

Mohammed Sadeq Hamzah Al-Ruwaiee

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Chest Pain ◽

Troponin I ◽

Statistical Significance ◽

Acute Chest Pain ◽

Blood Analysis ◽

P Value ◽

Cross Sectional ◽

Time Of Admission

Background: Cardiac Troponins-I (CTNI) are myoregulatory polypeptides that control the actin-myosin interface, considered specific to cardiomyocytes. Age and sex variances in the extent of CTNI levels have arisen a recent debatable emphasis. Existing revisions do not display a reliable clinical power of sex-specific CTNI 99th centiles, which actually might mirror procedural aspects. Nevertheless, from a biochemical viewpoint, the trends of sex-specific CTNI 99th centiles seem sensible for the ruling-in of acute myocardial infarction AMI. Vulnerable females may be missed when applying the male sex-specific threshold. This study aimed to determine whether gender differences in CTNI exist in patients with AMI presented with chest pain. Methodology: The study was a cross-sectional, single-center, included 236-patients with AMI diagnosis by cardiologists at Merjan teaching hospital during the period from April to July 2020 from patients attending the hospital for cardiac consultation complaining of acute chest pain suggestive of AMI. Blood analysis had initiated at the time of admission included serum creatinine, blood urea, R/FBS, WBCs, PCV, and serum CTNI. A p-value below 0.05 specifies statistical significance. All statistical bioanalyses had performed by IBM-SPSS, version-25 for Windows. Results: The mean age of participants was 67.5 years, the men were dominant 76.2%. The incidence of DM and hypertension were significantly high and 24.5% of the patients were current smokers. Biochemical serum analysis revealed mean creatinine, urea, sugar, and STI values were 79.8±4.2 mmol/l, 15.9±1.7 mmol/l, 10.9±0.9 mmol/l, and 7.9±0.6 ng/ml separately. Both hypertension and smoking were significantly (p-0.001) more among males compared to the females, which is not the case for the prevalence of DM. The males were heavier significantly than females (p-0.001). Almost, there was no impact of gender on most of the other study variables other than serum TNI levels, which were significantly higher among the males (p-0.001). Conclusion: In patients with AMI presented with acute chest pain, the routine of CTNI in the diagnosis of AMI is based on the patient's gender. The application of gender-dependent cutoff levels for CTNI analyses appears to be highly suggested.

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Risk of acute myocardial infarction among new users of chondroitin sulfate: A nested case-control study

PLoS ONE ◽

10.1371/journal.pone.0253932 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253932

Author(s):

Ramón Mazzucchelli ◽

Sara Rodríguez-Martín ◽

Alberto García-Vadillo ◽

Miguel Gil ◽

Antonio Rodríguez-Miguel ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiovascular Risk ◽

Chondroitin Sulfate ◽

Index Date ◽

Case Control Study ◽

Case Control ◽

High Cardiovascular Risk ◽

Incident Cases ◽

Control Study

Objective To test the hypothesis that the use of chondroitin sulfate (CS) or glucosamine reduces the risk of acute myocardial infarction (AMI). Design Case-control study nested in a primary cohort of patients aged 40 to 99 years, using the database BIFAP during the 2002–2015 study period. From this cohort, we identified incident cases of AMI and randomly selected five controls per case, matched by exact age, gender, and index date. Adjusted odds ratios (AOR) and 95% confidence interval (CI) were computed through a conditional logistic regression. Only new users of CS or glucosamine were considered. Results A total of 23,585 incident cases of AMI and 117,405 controls were included. Of them, 89 cases (0.38%) and 757 controls (0.64%) were current users of CS at index date, yielding an AOR of 0.57 (95%CI: 0.46–0.72). The reduced risk among current users was observed in both short-term (<365 days, AOR = 0.58; 95%CI: 0.45–0.75) and long-term users (>364 days AOR = 0.56; 95%CI:0.36–0.87), in both sexes (men, AOR = 0.52; 95%CI:0.38–0.70; women, AOR = 0.65; 95%CI:0.46–0.91), in individuals over or under 70 years of age (AOR = 0.54; 95%CI:0.38–0.77, and AOR = 0.61; 95%CI:0.45–0.82, respectively) and in individuals at intermediate (AOR = 0.65; 95%CI:0.48–0.91) and high cardiovascular risk (AOR = 0.48; 95%CI:0.27–0.83), but not in those at low risk (AOR = 1.11; 95%CI:0.48–2.56). In contrast, the current use of glucosamine was not associated with either increased or decreased risk of AMI (AOR = 0.86; 95%CI:0.66–1.08). Conclusions Our results support a cardioprotective effect of CS, while glucosamine seems to be neutral. The protection was remarkable among subgroups at high cardiovascular risk.

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ACUTE MYOCARDIAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.03.700 ◽

2013 ◽

Vol 20 (03) ◽

pp. 332-340

Author(s):

ATIF SITWAT HAYAT ◽

MUHAMMAD ADNAN BAWANY ◽

JAWAD AHMED QADRI ◽

Kiran Khalil

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Block ◽

Complete Heart Block ◽

Tertiary Care ◽

Anterior Wall ◽

P Value ◽

Inferior Wall ◽

Care Hospital ◽

Significant Difference

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.

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Comprehensive Study of Acute Myocardial Infarctions Triggers

10.1101/2020.07.03.20145987 ◽

2020 ◽

Author(s):

Kamal Khademvatani ◽

Amin Sedokani ◽

Sima Masudi ◽

Parisa Nejati ◽

Mir Hossein Seyed-Mohammadzad ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Health Care Systems ◽

Ischemic Heart ◽

Clinical Event ◽

P Value ◽

Cross Sectional

AbstractAimMyocardial infarction (MI) is one of the most important cardiovascular diseases. A trigger is an external stimulus, potential to create a pathological change leading to a clinical event. In addition to classic risk factors of ischemic heart disease and myocardial infarction, MI triggers play critical roles in the incidence of acute MI.Methods and ResultsThis is a cross-sectional study of 254 patients with the first acute myocardial infarction referring to Seyedoshohada heart center of Urmia, Iran were enrolled in the study within one year of study. After 48h of hospitalization and, treatment, and cardiac caring, the patients were provided with the questionnaire to collecting the history of the disease ad triggers. In addition to laboratory and paraclinical data, the analysis of the study was performed. Out of 220 (86.4%) patients with STEMI and 34 (13.6%) patients with NSTEMI, there were significant differences (P-value <0.05) in AMI triggers with LVEF (0.03), gender (0.027), residency and living area (0.039), occupation (0.002), smoking (0.008), abnormal serum TG levels (0.018) and the season of AMI occurrence (0.013). The mean age for AMI patients was 60.4±12.97 years old with a mean BMI of 26.65±4.35 kg/m2.ConclusionIn addition to classic risk factors of ischemic heart disease and myocardial infarction, health care systems and physicians must pay more attention to triggers that may induce an acute myocardial infarction in people with predisposing factors especially in the male sex, stressful and hand working jobs, and psychological and mental tension patients.

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Abstract 13776: The Impact of Race on In-hospital Quality of Care Among Young Adults With Acute Myocardial Infarction

Circulation ◽

10.1161/circ.142.suppl_3.13776 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Diana Benea ◽

Valeria Raparelli ◽

hassan behlouli ◽

Louise Pilote ◽

Rachel Dryer

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Young Adults ◽

Quality Of Care ◽

Clinical Characteristics ◽

Hospital Quality ◽

P Value ◽

White Race

Introduction: The extent to which race influences in-hospital quality of care among young adults with acute myocardial infarction (AMI) is unknown. We examined racial differences in in-hospital quality of AMI care in young adults and described the patient and/or clinical characteristics associated with potential disparities in care. Methods: Data from the GENESIS-PRAXY (Canada) and the VIRGO (U.S.) prospective cohorts of young adults with AMI were analyzed. Among a total of 4,048 adults with AMI (≤55 years) (median=49 years [IQR 44-52], 22% non-white, 58% women), we calculated an in-hospital quality of care score (QCS) for AMI (quality indicators divided by total, with higher scores indicating better care) based on AHA quality of care standards, reporting data disaggregated by race. We categorized race as white versus non-white, which included Black, Asian and North American Indigenous populations. Results: This cohort was comprised of 906 non-white individuals and 3142 white individuals. Non-white adults exhibited a clustering of adverse cardiac risk factors, psychosocial risk factors and comorbidities versus whites; they had higher rates of hypertension, diabetes, alcohol abuse and prior AMI and lower rates of physical activity. They were more likely to have a low SES and receive low social support, and were less likely to be employed, a primary earner, or married/living with a partner. Non-white individuals were also more likely to experience a NSTEMI and less likely to receive cardiac rehabilitation, smoking cessation counseling as well as dual antiplatelet therapy at discharge. Furthermore, non-white individuals had a lower crude QCS than whites (QCS=69.99 vs 73.29, P-value<0.0001). In the multivariable model adjusted for clinical and psychosocial factors, non-white race (LS Mean Difference=-1.49 95%CI -2.87, -0.11, P-value=0.0344) was independently associated with a lower in-hospital QCS. Conclusion: Non-white individuals with AMI exhibited higher rates of adverse psychosocial and clinical characteristics than white individuals yet non-white race was independently associated with lower in-hospital quality of care. Interventions are needed to improve quality of AMI care in non-white young adults.

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