Trends in the treatment practices and long-term outcomes in patients <55 years of age hospitalized with an acute myocardial infarction

Background: Much of our knowledge on patients' characteristics, clinical management, and post-discharge outcomes of acute myocardial infarction (AMI) is derived from clinical studies in middle-aged and older individuals with little contemporary information about the descriptive epidemiology of AMI in the relatively young. The objectives of our population-based study were to describe more than 3 decade long trends in the clinical features, treatment practices, and long-term outcomes of young adults discharged from the hospital after AMI. Methods: The population consisted of 2,142 AMI patients aged 35 to 54 years who were hospitalized with AMI at 11 central Massachusetts medical centers during 16 annual periods between 1975 and 2007. Results: The average age of our study population was 47 years, and 20% were women. Patients hospitalized during the most recent study years (1997-2007) were more likely to have previously diagnosed cardiovascular comorbidities, such as heart failure and hypertension, than those hospitalized during earlier study years (1975-1984). On the other hand, patients hospitalized during the most recent study years were less likely to have developed heart failure (13.7%) or stroke (0.7%) during their index hospitalization than those during the first decade under study (20.9% and 2.0% respectively). One and two-year death rates decreased significantly between 1975-1984 (6.2% and 9.0%, respectively) to 1997-2007 (3.8% to 6.1%). These trends were concomitant with increasing use of effective cardiac therapies and coronary interventions during hospitalization. Conclusion: The results of this community-wide investigation provide insights into the changing characteristics and long-term outcomes of young patients hospitalized with AMI