Abstract 10131: Baseline Characteristics, Quality of Care, and Short-Term outcomes of Young Patients Presenting with ST-Segment Elevation Myocardial Infarction: Insight from the Get With the Guidelines CAD Registry
Background: Young patients (≤45 years) presenting with ST-segment elevation myocardial infarction (STEMI) present unique challenges in not having the traditional risk factors. It is unknown if the quality of care and in-hospital outcomes differ considerably from their older counterparts.
Methods: 34,246 patients presenting with STEMI and enrolled in the AHA's Get With the Guidelines CAD registry were analyzed. The cohort was divided based on age less than equal to or greater than 45 years.
Results: Young patients accounted for 10.4% of all STEMI. Compared with older patients, younger patients were more likely to be men (76% vs. 64% P<0.0001), Hispanics (10.0% vs. 7.6% P<0.0001), black (11.4% vs. 6.9% P<0.0001), and smokers (66% vs. 35% P<0.0001) but less likely to have traditional cardiovascular risk factors. Young patients had similar or better quality/performance measures and had lower in-hospital mortality (1.5% vs. 6.6% P <0.001). Time trend analysis (2002 –2009) suggested an increase in “all or none” composite performance measures in both the younger and older patients with time (68% to 92%). Women had higher rates of in-hospital mortality compared with men. Significant interaction (P = 0.012) was noted for in-hospital deaths, such that younger women (vs. younger men) had even greater odds of death compared to older women (vs. older men) (Figure) without any interaction for composite performance measures.
Conclusions: In this largest series to date, young patients presenting with STEMI were more likely to be men, smokers, black, or Hispanic, whose quality of care, and in-hospital outcomes were similar or better than that of their older counterparts. There was a significant interaction between sex and in-hospital outcomes such that younger women had higher in-hospital mortality than younger men.
- © 2010 by American Heart Association, Inc.