November 14, 2018
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Acute MI hospitalizations in young adults rising, especially in women

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Sameer Arora

CHICAGO — Hospitalizations for acute MI in younger patients rose between 1995 and 2014, particularly in women, according to data presented at the American Heart Association Scientific Sessions.

“Recent reports have shown an increasing prevalence of cardiovascular risk factors in young. However, we have limited knowledge if this increasing burden of risk factors has translated into a higher incidence of heart attacks in young population,” Sameer Arora, MD, from the division of cardiology at the University of North Carolina School of Medicine, Chapel Hill, told Cardiology Today.

Arora and colleagues analyzed 8,737 patients aged 35 to 54 years from the ARIC cohort who were hospitalized for acute MI between 1995 and 2014.

According to the researchers, during the study period, the annual rate of acute MI increased in young women but decreased in young men.

The proportion of young adults accounting for acute MI admissions rose from 27% in 1995-1999 to 32% in 2010-2014 (P for trend = .002), with women accounting for more of the increase than men, Arora and colleagues found.

Over time, young patients with acute MI were more likely to have a history of hypertension (from 59% to 73%; P for trend < .001) and diabetes (from 25% to 35%; P for trend < .001).

Compared with young men, young women were more likely to be of black race and had more comorbidities.

In adjusted analyses, compared with young men, young women were less likely to receive lipid-lowering therapies (RR = 0.87; 95% CI, 0.8-0.94), non-aspirin antiplatelets (RR = 0.83; 95% CI, 0.75-0.91), beta-blockers (RR = 0.96; 95% CI, 0.91-0.99), coronary angiography (RR = 0.93; 95% CI, 0.86-0.99) and coronary revascularization (RR = 0.79; 95% CI, 0.71-0.87). However, there was no significant difference in 1-year mortality (RR = 1.1; 95% CI, 0.83-1.45).

“In this study, we found that the proportion of heart attacks in the young as compared with the overall population are increasing, particularly in young women. We also found that young women were less likely to be treated with guidelines directed therapies for heart attack as compared with young men,” Arora told Cardiology Today. “This has great implications, as it is crucial to focus on young women as a group and improve their care at every level, including primary and secondary prevention of heart attacks.” – by Erik Swain

References:

Arora S, et al. Elizabeth Barrett-Connor Research Award for Young Investigators in Training Competition. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Arora S, et al. Circulation. 2018;doi:10.1161/CIRCULATIONAHA.118.037137.

Disclosure: Arora reports no relevant financial disclosures.