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2016年至2020年美国青少年急性心肌梗死:来自全国住院患者样本的回顾性分析

Acute myocardial infarction among teenagers in the United States between 2016 and 2020: a retrospective analysis from the National Inpatient Sample.

作者信息

Ramphul Kamleshun, Aggarwal Shruti, Verma Renuka, Lohana Petras, Sombans Shaheen, Ramphul Yogeshwaree, Mejias Stephanie Gonzalez, Kumar Deepak, Kwansa Nana Amma, Pekyi-Boateng Prince Kwabla

机构信息

Independent Researcher, Mauritius.

Independent Researcher, Punjab, India.

出版信息

Arch Med Sci Atheroscler Dis. 2023 Dec 30;8:e177-e181. doi: 10.5114/amsad/168637. eCollection 2023.

Abstract

INTRODUCTION

There is a lack of data on the characteristics of teenagers admitted with acute myocardial infarction (AMI). Recent studies have hinted that with changes in lifestyle and easier access to substances of abuse, people may be prone to several cardiovascular complications at an earlier age.

MATERIAL AND METHODS

Our analysis was based on the 2016-2020 National Inpatient Samples. Logistic models allowed us to investigate the adjusted odds ratios (aOR) of AMI among teenagers. We explored outcomes and complications such as cardiogenic shock, extracorporeal membrane oxygenation (ECMO), coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), and mortality in these patients.

RESULTS

A total of 2170 cases of AMI were recorded between 2016 and 2020 (53.3 cases per 100,000 admissions among teenagers). Weekend admissions (26.3% vs. 20.9%, aOR = 1.298, < 0.001), smokers (15.9% vs. 10.1%, aOR = 1.198, = 0.007), cannabis users (18.9% vs. 8.4%, aOR = 1.558, < 0.001), or cocaine users (5.3% vs. 0.6%, aOR = 4.84, < 0.001) showed increased odds of recording a diagnosis of AMI. Females showed lower odds than males (32.7% vs. 65%, aOR = 0.264, 95% CI: 0.24-0.291, < 0.001). Admissions were more likely among teenagers with hypertension (9.9% vs. 2.5%, aOR = 3.382, < 0.001). Those not covered by Medicaid or private insurances were more likely to be admitted for AMI than Medicaid beneficiaries (12.4% vs. 8.2%, aOR = 1.278, < 0.001). Finally, teenagers classified as Blacks showed higher odds than whites of being admitted for AMI (aOR = 1.37, < 0.001). A total of 270 (12.5%) deaths were also noted.

CONCLUSIONS

Various characteristics among teenagers influence their risk for AMI. Further studies and campaigns on educating teenagers about risk factors may provide long-term benefits.

摘要

引言

目前缺乏关于青少年急性心肌梗死(AMI)患者特征的数据。最近的研究表明,随着生活方式的改变以及更容易接触到滥用物质,人们可能在更早的年龄就容易出现多种心血管并发症。

材料与方法

我们的分析基于2016 - 2020年的全国住院患者样本。逻辑模型使我们能够研究青少年中急性心肌梗死的调整后比值比(aOR)。我们探讨了这些患者的心源性休克、体外膜肺氧合(ECMO)、冠状动脉旁路移植术(CABG)、经皮冠状动脉介入治疗(PCI)等结局和并发症以及死亡率。

结果

2016年至2020年期间共记录了2170例急性心肌梗死病例(青少年中每10万例入院患者中有53.3例)。周末入院(26.3%对20.9%,aOR = 1.298,P < 0.001)、吸烟者(15.9%对10.1%,aOR = 1.198,P = 0.007)、大麻使用者(18.对8.4%,aOR = 1.558,P < 0.001)或可卡因使用者(5.3%对0.6%,aOR = 4.84,P < 0.001)被诊断为急性心肌梗死的几率增加。女性的几率低于男性(32.7%对65%,aOR = 0.264,95%置信区间:0.24 - 0.291,P < 0.001)。高血压青少年入院的可能性更大(9.9%对2.5%,aOR = 3.382,P < 0.)。未参加医疗补助或私人保险的青少年因急性心肌梗死入院的可能性高于医疗补助受益患者(12.4%对8.2%,aOR = 1.278,P < 0.001)。最后,被归类为黑人的青少年因急性心肌梗死入院的几率高于白人(aOR = 1.37,P < 0.001)。还记录到共有270例(12.5%)死亡病例。

结论

青少年的各种特征会影响他们患急性心肌梗死的风险。关于向青少年宣传风险因素的进一步研究和活动可能会带来长期益处。

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