The following article is a part of conference coverage from the American Heart Association Scientific Sessions 2021, being held virtually from November 13 to 15, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by leading experts in cardiology. Check back for more from the AHA Scientific Sessions 2021.
In the last decade, Black adults aged 18 to 44 years in the United States have experienced increasing cardiovascular disease (CVD) risk factors and worsened in-hospital outcomes, such as major adverse cardiac events (MACE) and stroke, according to study results presented at the American Heart Association (AHA) Scientific Sessions 2021, held from November 13 to 15, 2021.
For the study, researchers used the National Inpatient Sample databases to identify young, Black adults who had been hospitalized in 2007 and 2017. Investigators compared sociodemographic factors, comorbidities, and inpatient outcomes, including MACE (all-cause mortality, acute myocardial infarction [AMI], cardiac arrest, cardiogenic shock, coronary intervention, pulmonary embolism [PE], ventricular fibrillation/flutter [VF/flutter], atrial fibrillation/flutter [AF/flutter]) between the 2017 and 2007 cohorts. Researchers also performed multivariable analyses, controlling potential covariates.
Patients from the 2017 and 2007 cohorts had a mean age of 30 and 31 years; 30.4% and 28.8% were men; and 76.8% and 75% (P <.001) were men with higher nonelective admissions, respectively. Researchers also indicated an increasing burden of traditional cardiometabolic comorbidities, chronic pulmonary disease, coagulopathy, congestive heart failure, and depression, as well as decreased rates of alcohol and drug use.
Using an adjusted multivariable analysis, investigators identified worsening in-hospital outcomes in the 2017 vs 2007 cohort, including MACE (adjusted odds ratio [aOR] 1.21), VF/flutter (aOR 1.32), AMI (aOR 1.34), AF/flutter (aOR 1.34), stroke (aOR 1.53), PE (aOR 1.89), cardiac arrest (aOR 2.55), and cardiogenic shock (aOR 3.12), but a decreased rate of percutaneous coronary intervention, coronary artery bypass grafting, and all-cause mortality (P <.001).
“There should be more public awareness about the existence and availability of health counseling, health campaigns, and health fairs that can be accessed through nonprofit organizations, charitable community service, and the physician,” Dr Ankit Vyas, the study’s senior author, said. “Young people should be encouraged to work with case managers, social workers, physicians, nurses, pharmacists, or other health care professionals to learn more about affordable options that may be available to them.”
The study was limited by basing data on a population from a specific time and not including follow-up on data, lab findings, or medication history.
Desai R, Went TR, Koshiya H, et al. Rising burden of cardiovascular disease risk and major adverse cardiac events in young African American patients: a national analysis of two cohorts 10-years apart (2017 vs. 2007). Presented at: AHA Scientific Sessions 2021; November 13-15, 2021. Presentation RF40.
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