Changing Trends of Atherosclerotic Risk Factors Among Patients with Acute Myocardial Infarction and Acute Ischemic Stroke

• Published in: The American journal of cardiology Vol. 119; no. 10; pp. 1532 - 1541
• Main Authors: Agarwal, Shikhar, MD, MPH, Sud, Karan, MD, Thakkar, Badal, MD, Menon, Venu, MD, Jaber, Wael A., MD, Kapadia, Samir R., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.05.2017; Elsevier Limited
• Subjects: Aged; Arteriosclerosis; Atherosclerosis; Atherosclerosis - complications; Atherosclerosis - epidemiology; Cardiovascular; Cardiovascular disease; Cerebral infarction; Demographics; Demography; Diabetes mellitus; Disorders; Female; Follow-Up Studies; Health risk assessment; Health risks; Heart attacks; Humans; Hyperlipidemia; Hypertension; Incidence; Ischemia; Male; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Obesity; Patients; Prevalence; Retrospective Studies; Risk analysis; Risk Assessment - methods; Risk Factors; Smoking; Socioeconomic factors; Stroke; Stroke - epidemiology; Stroke - etiology; Survival Rate - trends; Trends; United States - epidemiology; United States > US; Acute myocardial infarction; Acute ischemic stroke; Mortality; Risk factors; Smoking
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.02.027

Abstract We aimed to evaluate the secular trends in demographics, risk factors as well as clinical characteristics of patients presenting with acute myocardial infarction (AMI) or acute ischemic stroke (AIS), using a large nationally representative dataset of in-hospital admissions. We used the 2003-2013 Nationwide Inpatient Sample. All admissions with primary diagnosis of AMI or AIS were included. Across 2003-2013, a total of 1,360,660 patients with AMI and 937,425 patients with AIS were included in the study. We noted a progressive reduction in the mean age of patients presenting with AMI and AIS (p-trend <0.001 for all groups), implying that the burden of young patients with these acute syndromes is progressively increasing. In addition, there was a progressive increase in the proportion of patients who are uninsured among patients presenting with AMI and AIS. Furthermore, despite a progressively younger age at presentation, there was an observed increase in the prevalence of atherosclerotic risk factors including hypertension, hyperlipidemia, diabetes, smoking and obesity among patients presenting with AMI or AIS during 2003-2013. Significant disparities were noted in the prevalence of risk factors among various demographic and geographical cohorts. Low socioeconomic status (SES) as well as uninsured patients had a significantly higher prevalence of preventable risk factors like smoking and obesity as compared to the high SES and insured patients respectively. In conclusion, there have been significant changes in the risk factor profile of patients presenting with AMI and AIS over the last decade.