title: Acute myocardial infarction in pregnancy: a statewide analysis.
abstract: OBJECTIVE
  Acute myocardial infarction (AMI) during pregnancy and the puerperium is a rare but devastating event. The objective of this study was to describe the clinical and epidemiological features of pregnancy-related AMI.
  
  
  METHODS
  A retrospective study was conducted using Texas hospital inpatient data (years 2004-2007). Diagnoses and procedures had been coded using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Adjusted odds ratios (OR) for hospital mortality and length of stay >4 days (prolonged length of stay [PLOS]) were calculated using logistic regression with Firth's bias correction and multiple imputation.
  
  
  RESULTS
  103 women with pregnancy-related AMI were identified in the statewide hospital database (6.5 cases per 100,000 births). The prevalence of cardiomyopathy was 16.5%. Approximately 14% of the pregnancies were complicated by preeclampsia/eclampsia. A history of cocaine use was noted in 3 patients. Congestive heart failure was present in 18 patients (17.5%). Two patients had attempted suicide and 1 died in the hospital. The overall hospital mortality rate was 9.7%. Placement of coronary artery stents was the most common coronary revascularization procedure (11 patients or 10.7%). The adjusted hospital mortality OR for women 35-39 years old (versus 30-34 years old) was 6.29 (P = .07). Patients with preeclampsia were more likely to have PLOS than patients whose deliveries were not complicated by preeclampsia (OR, 3.84; P = .06).
  
  
  CONCLUSIONS
  While AMI in pregnancy remains a rare occurrence, it is associated with significant morbidity and a high case-fatality rate.
authors.forename: Zuber D
authors.initials: ZD
authors.lastname: Mulla
authors.forename: Bailey
authors.initials: B
authors.lastname: Wilson
authors.forename: Zainul
authors.initials: Z
authors.lastname: Abedin
authors.forename: Loretta L
authors.initials: LL
authors.lastname: Hernandez
authors.forename: Sanja Kupesic
authors.initials: SK
authors.lastname: Plavsic
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D038801:International Classification of Diseases; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology