TY - JOUR
T1 - Cardiovascular Disease Burden and Major Adverse Cardiac Events in Young Black Patients
T2 - A National Analysis of 2 Cohorts 10 Years Apart (2017 Versus 2007)
AU - Vyas, Ankit
AU - Desai, Rupak
AU - Went, Terry Ricardo
AU - Wiltshire, Dwayne
AU - Priyadarshni, Shivani
AU - Shalaby, Mostafa
AU - Khalife, Wissam
N1 - Publisher Copyright:
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - 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.
AB - 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.
KW - Black individuals
KW - all-cause mortality
KW - cardiovascular disease risk factors
KW - disparities
KW - major adverse cardiac events
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U2 - 10.1161/JAHA.123.029895
DO - 10.1161/JAHA.123.029895
M3 - Article
C2 - 37489730
AN - SCOPUS:85166759319
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 15
M1 - e029895
ER -