Acute Myocardial Infarction Hospitalization Rate Decreasing for Young Smokers

Young smokers in 2017 were more likely to have other comorbid conditions including hypertension, diabetes, and obesity.

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.