Outcomes of Acute Myocardial Infarction in Patients with Familial Hypercholesteremia |
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| Authors: | Ayman Elbadawi Islam Y Elgendy Mohamed Omer Mohamed Abdelazeem Vijay Nambi Chayakrit Krittanawong Ravi S Hira Jacqueline Tamis-Holland Christie Ballantyne Hani Jneid |
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| Institution: | 1. Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston;2. Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar;3. Division of Cardiology, Mayo Clinic, Rochester, Minn;4. Department of Internal Medicine, St. Elizabeth''s Medical Center, Brighton, Mass;5. Section of Cardiology, Baylor School of Medicine, Houston, Tex;6. Pulse Heart Institute, Tacoma, Wash;7. Foundation for Health Care Quality, Seattle, Wash;8. Mount Sinai St. Luke''s Hospital, New York, NY;1. Department of Philosophy, Texas Tech University, Lubbock;2. Texas Tech University Health Sciences Center, School of Medicine, Lubbock;1. Department of General Internal Medicine, University of Chicago, IL;2. Department of Medicine and Pediatrics, Warren Alpert School of Medicine at Brown University, Providence, RI;3. Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Md;4. Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, Md;5. Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Md;6. Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Md;7. Department of Internal Medicine, Virginia Commonwealth University Health, Richmond, CO;8. Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, VA;1. Department of Medicine, Cleveland Clinic, Cleveland, Ohio;2. Department of Medicine, Cleveland Clinic Akron General, Akron, Ohio;3. Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio;1. Department of General Medicine, Chiba University Hospital, Japan;2. Department of Radiology, Chiba University Hospital, Japan |
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| Abstract: | BackgroundThere is a paucity of contemporary data regarding the outcomes of acute myocardial infarction among patients with familial hypercholesteremia.MethodsWe queried the Nationwide Readmissions Database (2016-2018) for hospitalizations with acute myocardial infarction. Multivariable regression analysis was used to compare in-hospital outcomes and 30-day readmissions among patients with and without familial hypercholesteremia.ResultsThe analysis included 1,363,488 hospitalizations with acute myocardial infarction. The prevalence of familial hypercholesteremia was 0.07% among acute myocardial infarction admissions. Compared with those without familial hypercholesteremia, admissions with familial hypercholesteremia were younger and had less comorbidities but were more likely to have had prior infarct and revascularization. Admissions with familial hypercholesteremia were more likely to present with ST-elevation myocardial infarction and undergo revascularization. After multivariable adjustment, there was no difference in in-hospital case fatality among patients with hypercholesteremia compared with those without it (adjusted odds ratio aOR] = 0.76; 95% confidence interval CI] 0.41-1.39). Admissions with acute myocardial infarction and familial hypercholesteremia had higher adjusted rates of cardiac arrest and utilization of mechanical support. There were no group differences in overall 30-day readmission (aOR 0.75; 95% CI 0.51-1.10) or 30-day readmission for acute myocardial infarction. However, a nonsignificant trend toward higher readmission for percutaneous coronary intervention was observed among patients with familial hypercholesteremia (aOR 1.89; 95% CI 0.98-3.64).ConclusionIn this contemporary nationwide observational analysis, patients with familial hypercholesteremia represent a small proportion of the overall population with acute myocardial infarction and have a distinctive clinical profile but do not appear to have worse in-hospital case fatality compared with those without familial hypercholesteremia. |
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| Keywords: | Acute myocardial infarction Dyslipidemia Familial hypercholesteremia ST-elevation myocardial infarction Premature coronary artery disease |
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