Trends in the magnitude of chronic conditions in patients hospitalized with a first acute myocardial infarction.
Multimorbidity
comorbidities
myocardial infarction
Journal
Journal of multimorbidity and comorbidity
ISSN: 2633-5565
Titre abrégé: J Multimorb Comorb
Pays: England
ID NLM: 9918333280706676
Informations de publication
Date de publication:
Historique:
received:
09
12
2020
revised:
09
12
2020
accepted:
05
02
2021
entrez:
19
3
2021
pubmed:
20
3
2021
medline:
20
3
2021
Statut:
epublish
Résumé
Among adults with heart disease, there is a high prevalence of concomitant chronic medical conditions. We studied patients with a first acute myocardial infarction to describe: sample population characteristics; trends of the most prevalent pairs of chronic conditions; and differences in hospital management according to burden of these morbidities. Patients (n = 1,564) hospitalized with an incident AMI at the 3 major medical centers in central Massachusetts during 2005, 2011, and 2015 comprised the study population. Hospital medical records were reviewed to identify 11 more prevalent chronic conditions. The median age of this population was 68 years and 56% were men. The median number of previously diagnosed chronic conditions was 2. Patients hospitalized during 2015 were more likely to be younger than those hospitalized in the earliest study cohorts. The most common pairs of chronic conditions for those hospitalized in 2005 were: anemia-chronic kidney disease (31%), chronic kidney disease-heart failure (30%), and stroke-atrial fibrillation (27%). Among patients hospitalized during 2011, chronic kidney disease-heart failure (29%), hypertension-hyperlipidemia (27%), and hypertension-diabetes (27%) were the most common pairs whereas hypertension-hyperlipidemia (43%), diabetes-heart failure (30%), and chronic kidney disease-diabetes (23%) were the most frequent pairs recorded in 2015. There was a significant decrease in the odds of undergoing cardiac catheterization and a percutaneous coronary intervention in those with higher chronic disease burden in the most recent as compared to earliest study years. Our findings highlight the magnitude of chronic conditions in patients with AMI and the challenges of caring for this vulnerable population.
Sections du résumé
BACKGROUND
Among adults with heart disease, there is a high prevalence of concomitant chronic medical conditions. We studied patients with a first acute myocardial infarction to describe: sample population characteristics; trends of the most prevalent pairs of chronic conditions; and differences in hospital management according to burden of these morbidities.
METHODS AND RESULTS
Patients (n = 1,564) hospitalized with an incident AMI at the 3 major medical centers in central Massachusetts during 2005, 2011, and 2015 comprised the study population. Hospital medical records were reviewed to identify 11 more prevalent chronic conditions. The median age of this population was 68 years and 56% were men. The median number of previously diagnosed chronic conditions was 2. Patients hospitalized during 2015 were more likely to be younger than those hospitalized in the earliest study cohorts. The most common pairs of chronic conditions for those hospitalized in 2005 were: anemia-chronic kidney disease (31%), chronic kidney disease-heart failure (30%), and stroke-atrial fibrillation (27%). Among patients hospitalized during 2011, chronic kidney disease-heart failure (29%), hypertension-hyperlipidemia (27%), and hypertension-diabetes (27%) were the most common pairs whereas hypertension-hyperlipidemia (43%), diabetes-heart failure (30%), and chronic kidney disease-diabetes (23%) were the most frequent pairs recorded in 2015. There was a significant decrease in the odds of undergoing cardiac catheterization and a percutaneous coronary intervention in those with higher chronic disease burden in the most recent as compared to earliest study years.
CONCLUSIONS
Our findings highlight the magnitude of chronic conditions in patients with AMI and the challenges of caring for this vulnerable population.
Identifiants
pubmed: 33738263
doi: 10.1177/2633556521999570
pii: 10.1177_2633556521999570
pmc: PMC7934031
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2633556521999570Subventions
Organisme : NIA NIH HHS
ID : R01 AG062630
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL035434
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG057806
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL105268
Pays : United States
Informations de copyright
© The Author(s) 2021.
Déclaration de conflit d'intérêts
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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