Myocardial infarction in adolescents.
OBJECTIVE
To determine the incidence, characteristics, and outcomes for adolescents diagnosed with acute myocardial infarction (AMI).


METHODS
We analyzed data from the Nationwide Inpatient Sample to determine the incidence of AMI in adolescents (age 13 to 18 years). Data from 1998 to 2001 were analyzed. Patients with primary cardiomyopathies, congenital heart lesions, and previous heart transplantation were excluded.


RESULTS
The estimated incidence of AMI admissions of adolescents in the United States is 157 per year, or 6.6 events per 1 million patient-years. AMI occurs predominantly in males (80%). Reported incidences of substance abuse and smoking are significantly higher in the adolescents with AMI than in adolescents admitted to the hospital for other conditions (P < .001 for both). Of the 123 subjects with AMI that we studied, 36 underwent coronary angiography (29%) and 2 underwent coronary artery bypass graft surgery (1%). The hospital mortality rate was 0.8%.


CONCLUSIONS
AMI is extremely rare in adolescents. Patient characteristics associated with AMI include substance abuse, tobacco use, and male sex. The hospital survival for AMI in adolescents is excellent, and the need for catheter or surgical coronary artery intervention is uncommon.
Mahle
William T
WT
Sibley Heart Center, Children's Healthcare of Atlanta and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322-1062, USA. wmahle@emory.edu
Campbell
Robert M
RM
Favaloro-Sabatier
Jennifer
J
D000293:Adolescent; D000367:Age Factors; D015331:Cohort Studies; D016001:Confidence Intervals; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods*; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000379:methods*; D014481:United States / Q000453:epidemiology