Abstract P375: Decade Long Trends in the Magnitude, Treatment, and Outcomes of Young Adults Hospitalized with ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Myocardial Infarction

Background: Although acute myocardial infarction (AMI) occurs primarily in the elderly, this disease also affects young adults. Few studies have, however, presented data on relatively young patients hospitalized with AMI. The objectives of this population-based study were to examine recent trends in the magnitude, management, and in-hospital and long-term-outcomes associated with either an initial ST-segment elevation acute myocardial infarction (STEMI) or non-ST-segment elevation acute myocardial infarction (NSTEMI) in patients between the ages of 30-54 years old. Methods: We reviewed the medical records of 745 residents of the Worcester (MA) metropolitan area between the ages of 30 and 54 years who were hospitalized for an initial STEMI or NSTEMI in 6 annual periods between 1997 and 2007 at 11 greater Worcester medical centers. Results: Between 1997 and 2007, the proportion of young adults hospitalized with an initial STEMI decreased from approximately two-thirds to two-fifths of all patients. Patients with STEMI were less likely to have a history of heart failure, hypertension, hyperlipidemia, and kidney disease than NSTEMI patients. Both groups were similarly treated with evidence-based therapies during their acute hospitalization with encouraging trends in the prescribing of various cardiac medications observed over time (Figures 1A and B). Important in-hospital clinical complications and mortality were low and no significant differences in these endpoints were observed between STEMI and NSTEMI patients. One year post-discharge death rates were also similar in both groups (1.9% vs. 2.8%). Conclusion: The present results demonstrate recent decreases in the proportion of relatively young patients diagnosed with an initial STEMI. Patients with STEMI and NSTEMI had similar in-hospital outcomes and long-term survival. Trends in these and other important outcomes warrant continued monitoring.