title: Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010.
abstract: BACKGROUND
  Various national campaigns launched in recent years have focused on young women with acute myocardial infarctions (AMIs). Contemporary longitudinal data about sex differences in clinical characteristics, hospitalization rates, length of stay (LOS), and mortality have not been examined.
  
  
  OBJECTIVE
  This study sought to determine sex differences in clinical characteristics, hospitalization rates, LOS, and in-hospital mortality by age group and race among young patients with AMIs using a large national dataset of U.S. hospital discharges.
  
  
  METHODS
  Using the National Inpatient Sample, clinical characteristics, AMI hospitalization rates, LOS, and in-hospital mortality were compared for patients with AMI across ages 30 to 54 years, dividing them into 5-year subgroups from 2001 to 2010, using survey data analysis techniques.
  
  
  RESULTS
  A total of 230,684 hospitalizations were identified with principal discharge diagnoses of AMI in 30- to 54-year-old patients from Nationwide Inpatient Sample data, representing an estimated 1,129,949 hospitalizations in the United States from 2001 to 2010. No statistically significant declines in AMI hospitalization rates were observed in the age groups <55 years or stratified by sex. Prevalence of comorbidities was higher in women and increased among both sexes through the study period. Women had longer LOS and higher in-hospital mortality than men across all age groups. However, observed in-hospital mortality declined significantly for women from 2001 to 2010 (from 3.3% to 2.3%, relative change 30.5%; p for trend < 0.0001) but not for men (from 2% to 1.8%, relative change 8.6%; p for trend = 0.60).
  
  
  CONCLUSIONS
  AMI hospitalization rates for young people have not declined over the past decade. Young women with AMIs have more comorbidity, longer LOS, and higher in-hospital mortality than young men, although their mortality rates are decreasing.
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Aakriti
authors: A
authors: Gupta
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Yongfei
authors: Y
authors: Wang
authors: St. Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri.
authors: John A
authors: JA
authors: Spertus
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors: Mary
authors: M
authors: Geda
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors: Nancy
authors: N
authors: Lorenze
authors: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; VA Center for Health Equity and Research Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania; Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Chileshe
authors: C
authors: Nkonde-Price
authors: Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Gail
authors: G
authors: D'Onofrio
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
authors: Judith H
authors: JH
authors: Lichtman
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut; Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut. Electronic address: harlan.krumholz@yale.edu.
authors: Harlan M
authors: HM
authors: Krumholz
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009203:Myocardial Infarction / Q000208:ethnology*; D010351:Patient Discharge / Q000639:trends; D015995:Prevalence; D044469:Racial Groups; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
keywords: acute myocardial infarction; hospitalization; sex differences; trends; young women