Acute MI Rates Increased From 2014-2017 During Pregnancy, Puerperium

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More than half of pregnancy-related AMI cases underwent invasive management and 25.1% underwent coronary revascularization.
More than half of pregnancy-related AMI cases underwent invasive management and 25.1% underwent coronary revascularization.

HealthDay News — Acute myocardial infarction (AMI) occurred in one of every 12,400 hospitalizations for those hospitalized during pregnancy and the puerperium, according to a study published online July 18 in the Mayo Clinic Proceedings.

Nathaniel R. Smilowitz, M.D., from the New York University School of Medicine in New York City, and colleagues identified women aged 18 years or older hospitalized during pregnancy and the puerperium from the National Inpatient Sample database from Jan. 1, 2002, to Dec. 31, 2014. AMI was identified during pregnancy-related admissions.

The researchers identified 55,402,290 pregnancy-related hospitalizations. There were 4,471 cases of AMI (8.1 cases per 100,000 hospitalizations), with 20.6, 23.7, and 53.5 percent identified in the antepartum period, during labor and delivery, and in the postpartum period, respectively. 

ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction occurred in 42.4 and 57.6 percent of cases, respectively. Overall, 53.1 percent of pregnancy-related AMI cases underwent invasive management and 25.1 percent underwent coronary revascularization. Patients with versus those without AMI during pregnancy had significantly higher in-hospital mortality (adjusted odds ratio, 39.9; P < 0.001). Over time there was an increase in the rate of AMI during pregnancy and the puerperium (adjusted odds ratio, 1.25 for 2014 versus 2002).

In patients hospitalized during pregnancy and the puerperium, "rates of AMI increased over time," the authors write. "Additional research on the prevention and optimal management of AMI during pregnancy is necessary."

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