Temporal Trends In Drug Abuse In Adults With Acute Myocardial Infarction Show Worse Outcomes

ObjectiveTo determine temporal trends, invasive treatment utilization and impact on outcomes of pre-infarction drug abuse (DA) on acute myocardial infarction (AMI) in adults.BackgroundDA is important risk factor for AMI. However, temporal trends in drug abuse on AMI hospitalization outcomes in adults are lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012. We identified AMI and DA as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and used the CochraneArmitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 7,174,274 AMI hospital admissions from 2002 to 2012 of which 1.67% had DA. Proportion of hospitalizations with DA increased from 5.63% to 12.08% (P trend < 0.001). Utilization of coronary artery bypass grafting (CABG) was lower in patients with DA (7.83% vs. 9.18%, P < 0.001). In-hospital mortality was significantly lower in patients with DA (aOR 0.811; 95% CI 0.693–0.735; P < 0.001) but discharge to specialty care was higher (aOR 1.076; 95% CI 1.025–1.128; P < 0.001). The median cost of hospitalization (40,834 vs. 37,253; P < 0.001) was higher in hospitalizations with DA.ConclusionsWe demonstrate an increasing proportion of adults admitted with AMI have DA over the decade. However, DA has paradoxical association with mortality in adults. DA is associated with lower CABG utilization and higher discharge to specialty care, with a higher mean cost of hospitalization. The reasons for the paradoxical association of DA with mortality and worse morbidity outcomes need to be explored in greater detail.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Faculty Opinions recommendation of Temporal trends and outcomes of patients undergoing percutaneous coronary interventions for cardiogenic shock in the setting of acute myocardial infarction: A report from the cathpci registry.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726098795.793532141 ◽

2017 ◽

Author(s):

Navin Kapur

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiogenic Shock ◽

Temporal Trends ◽

Percutaneous Coronary Interventions ◽

Coronary Interventions ◽

Percutaneous Coronary

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Temporal trends and patient characteristics associated with 30-day hospital readmission rates after a first acute myocardial infarction

The American Journal of Medicine ◽

10.1016/j.amjmed.2021.03.024 ◽

2021 ◽

Author(s):

Mayra Tisminetzky ◽

Jordy Mehawej ◽

Ruben Miozzo ◽

Jerry H. Gurwitz ◽

Joel M. Gore ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Readmission ◽

Temporal Trends ◽

Patient Characteristics ◽

Day Hospital ◽

Readmission Rates ◽

Hospital Readmission Rates

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Abstract 11133: The Incidence and Predicting Factors of Heart Failure After First Acute Myocardial Infarction: A Population[[Unable to Display Character: ‐]]Based Study in Taiwan

Circulation ◽

10.1161/circ.130.suppl_2.11133 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Cheng-Han Lee ◽

Yi-Heng Li ◽

Ching-Lan Cheng ◽

Jyh-Hong Chen ◽

Yea-Huei Kao Yang

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Coronary Revascularization ◽

Temporal Trends ◽

Population Based ◽

Research Database ◽

Index Hospitalization ◽

Predicting Factors ◽

One Year

Background: Early coronary revascularization and medical therapy advancement improve the survival of patients (pts) with acute myocardial infarction (AMI). However, survivors of AMI are at heightened risk of developing heart failure (HF) and there is a paucity of information regarding this issue in Asian countries. This study described the temporal trends in the incidence of HF after the first AMI and the predicting factors of HF development in Taiwan. Methods: We conducted a nationwide population-based cohort study by using 1999 to 2009 National Health Insurance Research Database. Pts aged≧18 years, with no history of HF, who hospitalized with a first AMI between January 2002 and December 2008 were identified and followed up for one year. The primary outcome was HF. We evaluated the incidence of HF during the index hospitalization, 30 days, 6 months, and one year after the discharge. The predicting factors of HF were identified by Cox proportional hazard model. Results: Overall, 42,011 first AMI pts (mean age 64.4 ± 13.8 years; male 75.0%) from 2002 to 2008 were identified. The HF incidence during the index hospitalization was 14.8%. After exclusion of HF during the hospitalization, the overall HF prevalence at 30 days, 6 months, and 1 year was 9.6%, 14.2%, and 16.8%, respectively. The HF prevalence at 1 year declined from 17.9% to 14.9% (p<0.05) from 2002 to 2008. The independent predicting factors of HF after the first AMI were elder age (≧65 years) (adjusted HR 1.81, 95% CI 1.51-2.18), diabetes mellitus (adjusted HR 1.30, 95% CI 1.21-1.41), chronic kidney disease (adjusted HR 1.41, 95% CI 1.20-1.65), use of loop diuretics within 30 days after the discharge (adjusted HR 2.21, 95% CI 2.00-2.43), and recurrent AMI (adjusted HR 2.43, 2.16-2.74). Conclusions: Survivors of AMI without prior HF remain at risk of developing HF in Taiwan and most episodes occur within 6 months after AMI. Five important clinical factors of HF were identified that may help us for risk stratification.

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Temporal Trends, Predictors and Outcomes of Inpatient Palliative Care Use in Cardiac Arrest Complicating Acute Myocardial Infarction

Resuscitation ◽

10.1016/j.resuscitation.2021.10.044 ◽

2021 ◽

Author(s):

Ardaas Kanwar ◽

Sri Harsha Patlolla ◽

Mandeep Singh ◽

Dennis H Murphree ◽

Pranathi R Sundaragiri ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Palliative Care ◽

Cardiac Arrest ◽

Temporal Trends

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Abstract 14759: Burden of Intracranial Hemorrhage in Patients With Acute Myocardial Infarction in the United States, 2000-2017

Circulation ◽

10.1161/circ.142.suppl_3.14759 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sri Harsha Patlolla ◽

Saraschandra Vallabhajosyula

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Length Of Stay ◽

Hospital Mortality ◽

Intracranial Hemorrhage ◽

Temporal Trends ◽

The United States ◽

Circulatory Support ◽

White Race ◽

Hospitalization Costs

Introduction: There is a paucity of contemporary data on the burden of intracranial hemorrhage (ICH) complicating acute myocardial infarction (AMI). Methods: The National Inpatient Sample database (2000 to 2017) was used to evaluate in-hospital burden of ICH in adult (>18 years) AMI admissions. In-hospital mortality, hospitalization costs, length of stay, and measure of functional ability were the outcomes of interest. The discharge destination along with use of tracheostomy and percutaneous endoscopic gastrostomy (PEG) were used to estimate functional burden. Results: Of a total 11,622,528 AMI admissions, 23,422 (0.2%) had concomitant ICH. Compared to those without, admissions with ICH were on average older, female, of non-White race, with greater comorbidities, and higher rates of arrhythmias (all p<0.001). Female sex, non-White race, ST-segment-elevation AMI presentation, use of fibrinolytics, mechanical circulatory support and invasive mechanical ventilation were identified as individual predictors of ICH. The AMI admissions with ICH received less frequent coronary angiography (46.9% vs. 63.8%), percutaneous coronary intervention (22.7% vs. 41.8%), and coronary artery bypass grafting (5.4% vs. 9.2%) as compared to those without (all p<0.001). ICH was associated with a significantly higher in-hospital mortality (41.4% vs. 6.1%; adjusted OR 5.65 [95% CI 5.47-5.84]; p<0.001), and adjusted temporal trends showed a steady decrease in in-hospital mortality over the 18-year period (Figure 1A). AMI-ICH admissions also had longer hospital length of stay, higher hospitalization costs, and greater use of PEG (all p<0.001). In AMI-ICH survivors (N=13, 689), 81.3% had a poor functional outcome indicating severe morbidity and temporal trends revealed a slight increase over the study period (Figure 1B). Conclusions: ICH causes a substantial burden in AMI due to associated higher in-hospital mortality, resource utilization, and poor functional outcomes.

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Temporal Trends and Factors Associated With Pulmonary Artery Catheterization in Patients With Acute Myocardial Infarction

CHEST Journal ◽

10.1378/chest.105.4.1003 ◽

1994 ◽

Vol 105 (4) ◽

pp. 1003-1008 ◽

Cited By ~ 13

Author(s):

Jorge Yarzebski ◽

Robert J. Goldberg ◽

Joel M. Gore ◽

Joseph S. Alpert

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Pulmonary Artery ◽

Temporal Trends ◽

Pulmonary Artery Catheterization ◽

Factors Associated

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Recent temporal trends for first-time hospitalization for acute myocardial infarction. Treatment patterns and clinical outcome in a large cohort study

American Heart Journal ◽

10.1016/j.ahj.2013.08.026 ◽

2013 ◽

Vol 166 (5) ◽

pp. 846-854 ◽

Cited By ~ 10

Author(s):

Paolo Ortolani ◽

Massimiliano Marino ◽

Giovanni Melandri ◽

Paolo Guastaroba ◽

Alessandro Corzani ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cohort Study ◽

Clinical Outcome ◽

Temporal Trends ◽

Treatment Patterns ◽

Large Cohort ◽

Large Cohort Study ◽

First Time

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Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312276 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12276

Author(s):

Jie Chang ◽

Qiuju Deng ◽

Moning Guo ◽

Majid Ezzati ◽

Jill Baumgartner ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Urban Areas ◽

Disease Surveillance ◽

Temporal Trends ◽

Relative Increase ◽

Mitigation Strategies ◽

Middle Aged ◽

Geographic Variations ◽

Cross Sectional

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle-aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

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