Cardiovascular Disease Burden and Major Adverse Cardiac Events in Young Black Patients: A National Analysis of 2 Cohorts 10 Years Apart (2017 Versus 2007)

Ankit Vyas, Rupak Desai, Terry Ricardo Went, Dwayne Wiltshire, Shivani Priyadarshni, Mostafa Shalaby, Wissam Khalife

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: We aim to compare the burden of cardiovascular disease risk factors and major adverse cardiac events and in-hospital outcomes among young Black patients (aged 18–44 years) hospitalized in 2007 and 2017 using data obtained from the National Inpatient Sample database. METHOD AND RESULTS: Comparison of the sociodemographic characteristics, comorbidities, and inpatient outcomes, including major adverse cardiac events (all-cause mortality, acute myocardial infarction, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, and coronary intervention), between 2017 and 2007 was performed. Multivariable analyses were performed, controlling for potential covariates. A total of 2 922 743 (mean age, 31 years; 70.3% women) admissions among young Black individuals were studied (1 341 068 in 2007 and 1 581 675 in 2017). The 2017 cohort had a younger population (mean, 30 versus 31 years; P<0.001), more male patients (30.4% versus 28.8%; P<0.001), and patients with higher nonelective admissions (76.8% versus 75%; P<0.001), and showed an increasing burden of traditional cardiometabolic co-morbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, along with notable reductions in alcohol abuse and drug abuse, compared with the 2007 cohort. The adjusted multivariable analysis showed worsening in-hospital outcomes, including major adverse cardiac events (adjusted odds ratio [aOR], 1.21), acute myocardial infarction (aOR, 1.34), cardiogenic shock (aOR, 3.12), atrial fibrillation/flutter (aOR, 1.34), ventricular fibrillation/flutter (aOR, 1.32), cardiac arrest (aOR, 2.55), pulmonary embolism (aOR, 1.89), and stroke (aOR, 1.53). The 2017 cohort showed a decreased rate of percutaneous coronary intervention/coronary artery bypass grafting and all-cause mortality versus the 2007 cohort (P<0.001). CONCLUSIONS: In conclusion, young Black patients have had an increasing burden of cardiovascular disease risk factors and worsened in-hospital outcomes, including major adverse cardiac events and stroke, in the past decade, although with im-proved survival odds.

Original languageEnglish (US)
Article numbere029895
JournalJournal of the American Heart Association
Volume12
Issue number15
DOIs
StatePublished - Aug 1 2023

Keywords

  • Black individuals
  • all-cause mortality
  • cardiovascular disease risk factors
  • disparities
  • major adverse cardiac events

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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