title: Characteristics and prognosis of acute myocardial infarction by discharge diagnosis: the Reasons for Geographic and Racial Differences in Stroke study.
abstract: OBJECTIVE
  To compare the characteristics and prognosis of acute myocardial infarctions (AMIs) that were not the primary reason for hospitalization, and thus not primary discharge diagnosis, to AMIs that were the primary reason for hospitalization.
  
  
  METHODS
  Primary discharge diagnoses for Reasons for Geographic and Racial Differences in Stroke study participants (black and white men and women age ≥45 years) with adjudicated AMIs were categorized as "AMI" or "other". Cox models were used to compare mortality up to 5 years post-AMI between primary discharge diagnoses of AMI and other.
  
  
  RESULTS
  Of 871 AMIs, primary discharge diagnosis was not AMI in 550 (63%). When primary discharge diagnosis was not AMI, average troponin elevations were smaller and heart failure was more common. Adjusted for participant and hospitalization characteristics, all-cause, coronary heart disease, and cardiovascular disease mortality after AMI were similar between groups (hazard ratios [95% confidence intervals]: 1.08 [0.80-1.47]; 1.29 [0.76-2.18]; and 0.86 [0.58-1.27], respectively).
  
  
  CONCLUSIONS
  Studies limited to individuals with primary discharge diagnosis of AMI may underestimate the burden of AMI and exclude a group with elevated risk of all-cause, coronary heart disease, and cardiovascular disease mortality.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham. Electronic address: elevitan@uab.edu.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham.
authors.forename: Olusola Top
authors.initials: OT
authors.lastname: Olubowale
authors.affiliation: Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Gamboa
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham.
authors.forename: J David
authors.initials: JD
authors.lastname: Rhodes
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Brown
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham.
authors.forename: Luqin
authors.initials: L
authors.lastname: Deng
authors.affiliation: Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology* / Q000401:mortality*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Mortality; Myocardial infarction; Prognosis