Abstract Body (Do not enter title and authors here): Background: The COVID-19 pandemic has significantly impacted healthcare systems and patient behaviors, potentially affecting cardiovascular disease prevalence and outcomes. This study aims to analyze trends in acute myocardial infarction (AMI)-related hospitalizations and in-hospital mortality by age and sex in California from 2016 to 2022, with a particular focus on the pandemic years 2020-2022.
Methods: This retrospective analysis utilized patient discharge data from California from 2016-2022. Nearly 25 million inpatient events were screened for primary ICD-10-CM diagnosis codes I21. Age-and-sex-standardized hospitalization rates (ASHR) and in-hospital mortality rates (IMR) per 100,000 population were calculated for ages 20 and over. The effects of pre- and post-COVID-19 periods on AMI Hospitalization and In-hospital Mortality events were evaluated using multivariate logistic regression (MLR), adjusting for age, gender, race/ethnicity, geographic region, and payer source. Results were interpreted using Adjusted Odds Ratios (AOR).
Results: The study identified 776,609 AMI-related hospitalizations and 81,210 in-hospital deaths (10.46%). ASHR increased from 288.9 in 2016 to 365.9 in 2022, with a significant acceleration during the pandemic period (2020-2022) compared to the pre-pandemic period (2016-2019). Young adults (20-44 years) exhibited an alarming increase in AMI prevalence during the pandemic years. For males, rates rose from 39.4 to 70.2 per 100,000, and for females from 17.7 to 35.2 per 100,000. IMR increased from 29.0 in 2016 to 36.9 in 2022, with a marked acceleration during the pandemic years. Mortality rates increased significantly for both males, from 31.31 to 41.52, and for females, from 26.84 to 32.65. MLR showed that the post-COVID period had significantly higher rates of hospitalizations and in-hospital deaths compared to the pre-COVID period. Hospitalizations increased by 31% (AOR=1.31; 95% CI=1.30-1.31; p<0.001) and deaths increased by 22.6% (AOR=1.23; 95% CI=1.21-1.25; p<0.001).
Conclusion: AMI-related hospitalizations and in-hospital mortality rates significantly increased in California from 2016 to 2022, with the steepest rises observed during the COVID-19 pandemic years. Young adults, particularly males, experienced a disproportionate surge in AMI prevalence. These findings suggest a substantial impact of the COVID-19 pandemic on cardiovascular health and underscore the need for targeted prevention and equitable care strategies.