A167JACC April 1, 2014

Volume 63, Issue 12

Acute Coronary Syndromes

variation in geographiC diStribution oF in-hoSpital mortality aSSoCiated With aCute myoCardial inFarCtion: a nationWide analySiS

Poster ContributionsHall CSunday, March 30, 2014, 9:45 a.m.-10:30 a.m.

Session Title: Acute Coronary Syndromes: STEMIAbstract Category: 1. Acute Coronary Syndromes: ClinicalPresentation Number: 1190-253

Authors: Sadip Pant, Abhishek Deshmukh, Kathan Mehta, Apurva Badheka, Nileshkumar Patel, Smith Giri, Neeraj Shah, Ankit Chothani, Tushar Tuliani, Kaustubh Dabhadkar, Jawahar Mehta, University of Arkansas for Medical Sciences, Little Rock, AR, USA

background: Mortality from acute myocardial infarction (AMI) has significantly declined nationwide due to various reasons. Data regarding geographic variation in mortality is however limited.

methods: Using the Nationwide Inpatient Sample (NIS) between the years 2000-2010, patients with primary diagnosis of AMI was obtained. We investigated the trends in in-hospital mortality, risk factors and procedures performed in different regions of the country.

results: There were a total of12,958,452 cases of AMI from 2000 to 2010. We noted an overall decline in mortality in all regions over this time span. However, the overall in-hospital mortality per 100,000 cases was highest in the South followed by Mid-west and North-east, with least in the West (Figure 1). There was significantly higher occurrence of traditional risk factors (diabetes mellitus, hypertension, smoking, obesity and hyperlipidemia) in the South compared to other regions (Table 1). Median household income was significantly lower in this region (Table 1). Racial variation analysis showed higher race-specific mortality in the South compared to the rest (Figure 2). This race-wise mortality variation in the South is more pronounced among African-American and Hispanics (Figure 2).

Conclusions: Although mortality from AMI is trending down across all regions of the US, it is proportionately higher in the South, perhaps related to uneven distribution of socio-economic and traditional risk factors in the South.