Abstract Body (Do not enter title and authors here): Intro
Mortality for patients hospitalized with acute myocardial infarction (AMI) has improved over time, but sex- and racial/ethnic disparities remain. Whether disparities have changed over specific time periods following hospitalization is poorly understood.
Aim
To assess mortality trends across separate time periods following incident AMI hospitalization by sex and race.
Methods
Using Medicare fee-for-service data covering all patients with incident AMI hospitalizations from 2008 to 2018, we examined unadjusted mortality rates by sex and race/ethnicity for the following time periods: acute (in-hospital), post-acute (0-30 days after hospital discharge), short term (31 days to 1 year after discharge), and long term (1-3 years after discharge). Each period was considered separately (i.e., patients who died during one period were not counted in later periods).
Results
We identified 768,084 patients hospitalized with incident AMI (mean age 81 years, 48% male, 87% White) between 2008-2018. Figures 1 and 2 show annual mortality rates and trends. From 2008-2018, men and women had similar in-hospital and post-acute mortality, but women had persistently higher short- and long-term mortality compared to men. In 2008, Black patients had higher mortality rates compared to White patients for every period studied. In-hospital mortality rates were similar by 2018 but remained higher for Black patients for every other time period.
Conclusions
For incident AMI patients, mortality rates have improved across subgroups through 3 years after discharge. However, women have had persistently higher mortality rates 1-3 years following hospitalization compared to men, while Black patients have had persistently higher mortality rates 30 days – 3 years following hospitalization compared to White patients. These results suggest that opportunities to reduce sex- and race-based AMI disparities might be particularly effective in longitudinal outpatient care following hospital discharge.