Acute Myocardial Infarction Hospitalization Rate Decreasing for Young Smokers

Ankit Vyas, MBBS

While hospitalization rates acute myocardial infarction (AMI) have decreased among young individuals who smoke between 2007-2017, there are a number of comorbid conditions that warrant monitoring.

In data presented during the 2021 American Heart Association (AHA) Scientific Sessions, a team, led by Ankit Vyas, MBBS, Baptist Hospital of Southeast Texas,compared the demographics, comorbidities, and outcomes of acute myocardial infarction hospitalizations for younger smokers across 2 national cohorts a decade apart.

The Data

The investigators used 2007 and 2017 data from the National Inpatient Sample to identify patients with acute myocardial infarction between 18-44 years who are also tobacco smokers.

Data selected included demographics, comorbidities, and outcomes such as all-cause mortality, cardiogenic shock, atrial/ventricular fibrillation/flutter.

The overall hospitalization rate for acute myocardial infarction decreased between 2007-2017, going from 1.7% (n = 23,592) in 2007 to 1.3% (n = 28,775) in 2017.

Demographic Trends

There were also trends found based on certain demographics. For example, compared to 2007, the 2017 consisted of more of female (30.8% vs 26.0%), non-white, and Medicaid enrollees (35.1% vs 15.9%), admitted to urban teaching facilities.

Young smokers in 2017 also had a number of other comorbid conditions to go with the acute myocardial infarction.

These included 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).

The 2017 patients also had higher all-cause mortality [2.7% vs 0.9%; OR,1.67; 95% CI 1.39-2.02], post-myocardial infarction complications like cardiogenic shock [3.5% vs 1.8%; OR, 1.40; 95% CI 1.21-1.62], atrial fibrillation/flutter [4.6% vs 1.7%; OR, 2.55; 95% CI, 2.21-2.96], ventricular fibrillation/flutter [3.3% vs 2.8%; OR, 1.24; 95% CI, 1.09-1.41], and lower routine discharges.

Even as hospital lengths of stay decreased in the 10 years between 2007 and 2017, hospital charges increased in 2017 (P <0.05).

“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,” the authors wrote.

The study, “Decreased Rate but Worsened Outcomes of Acute Myocardial Infarction-Related Hospitalizations Among Young Tobacco Smokers: A Decade Apart Nationwide Analysis (2007 vs 2017),” was published online by AHA.