Abstract 20300: Patient Characteristics, Treatment and Outcomes for Acute Myocardial Infarction Among American Indians
Background: American Indians are considered medically underserved and are typically underrepresented in registries and randomized controlled trials. Therefore, we sought to better understand the characteristics, comorbidities, treatments and outcomes of American Indians and Alaska Natives (AIAN) hospitalized with acute myocardial infarction (MI).
Methods: We analyzed data on all patients with a primary diagnosis of MI (410.XX) from the State Inpatient Databases of Arizona, California, Florida, New Mexico and New York from 2004-2013. We compared demographics, co-morbidities, rates of ST elevation myocardial infarction (STEMI), procedure utilization and outcomes between AIAN and other racial and ethnic groups. The primary outcomes of interest were death and recurrent MI.
Results: Of 825, 072 patients, 0.3% were AIAN, 70.7% were Caucasian and 29% were other races. AIAN were younger (64.8 ± 14 years vs. 68.8 ± 14.4 years, p<0.001), more often male (64.1% vs. 59.8%, p<0.001), less likely to have Medicare (48.6% vs. 59.3%, p<0.001), more likely to have Medicaid (16.6 vs. 7.5%, p<0.001) and had similar rates of private insurance as the primary payer (24.2% vs. 24.9%, p<0.001). They had a greater prevalence of diabetes (50.9% vs. 36.4%, p<0.001) compared to others but less hypertension (72.8% vs. 76.2%, p<0.001), and peripheral vascular disease (10.8% vs. 14% (p<0.001). Among all MI admissions, STEMI occurred with equal frequency in AIAN and other ethnicities (29.2% v 28.5%, p=0.38). PCI was performed on 38.8% of AIAN and 39.8% of others (p=0.24). CABG was performed on 12.1% of AIAN and 10.1% of others (p<0.001). In-hospital death occurred in 6.6% of AIAN and 6.9% of others (p=0.42). On multivariate analysis, AIAN ethnicity was not associated with an increased risk of death, readmission, or readmission for MI or readmission resulting in death.
Conclusions: In the population of patients admitted to non-federal hospitals with acute MI, AIAN had similar presentation, treatment and outcomes compared to other races and ethnicities.
Author Disclosures: T. Hagerty: None. E. Novak: None. D.L. Brown: None.
- © 2016 by American Heart Association, Inc.