Abstract:
:Background Pregnancy increases the risk of acute myocardial infarction (AMI). The purpose of this study was to examine timing and risk factors for AMI in pregnancy and poor outcome. Methods and Results National Inpatient Sample (2003-2015) was screened in pregnancy, labor and delivery, and postpartum. There were 11 297 849 records extracted with 913 instances of AMI (0.008%). One hundred eleven (12.2%) women experienced AMI during labor and delivery, 338 (37.0%) during pregnancy and most during the postpartum period (464; 50.8%). The prevalence of AMI in pregnancy has increased (P=0.0005). Most major adverse cardiovascular and cerebrovascular events occurred in the postpartum period (63.5%). Inpatient mortality was 4.5%. Predictors of AMI include known coronary artery disease (odds ratio [OR], 517.4; 95% CI, 420.8-636.2), heart failure (OR, 8.2; 95% CI, 1.9-35.2), prior valve replacement (OR, 6.4; 95% CI, 2.4-17.1), and atrial fibrillation (OR, 2.7; CI, 1.5-4.7; P<0.001). Risk factors of traditional atherosclerosis including hyperlipidemia, obesity, tobacco history, substance abuse, and thrombophilia were identified (P<0.001). Gestational hypertensive disorders (eclampsia OR, 6.0; 95% CI, 3.3-10.8; preeclampsia OR, 3.2; 95% CI, 2.5-4.2) were significant risk factors in predicting AMI. Risk factors associated with major adverse cardiovascular and cerebrovascular events included prior percutaneous coronary intervention (OR, 6.6; 95% CI, 1.4-31.2) and pre-eclampsia (OR, 2.3; 95% CI, 1.3-3.9). Conclusions AMI is associated with modifiable, nonmodifiable, and obstetric risk factors. These risk factors can lead to devastating adverse outcomes and highlight the need for risk factor modification and public health resource initiatives toward the goal of decreasing AMI in the pregnant population.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Balgobin CA,Zhang X,Lima FV,Avila C,Parikh PB,Yang J,Stergiopoulos Kdoi
10.1161/JAHA.120.016623subject
Has Abstractpub_date
2020-11-03 00:00:00pages
e016623issue
21issn
2047-9980journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Hypertension is a frequent risk factor for the development of heart failure with preserved ejection fraction (HFPEF). Progressive extracellular matrix accumulation has been presumed to be the fundamental pathophysiologic mechanism that leads to the transition to impaired diastolic reserve. However, the contr...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2017-01-10 00:00:00
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