Higher Risk of Bleeding in Asians Presenting With ST-Segment Elevation Myocardial Infarction: Analysis of the National Inpatient Sample Database

Authors

Naoki Misumida, Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA.
Gbolahan O. Ogunbayo, Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA.
Sun Moon Kim, Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA.
Odunayo Olorunfemi, Rochester Regional HealthFollow
Ayman Elbadawi, Rochester Regional HealthFollow
Richard J. Charnigo, Department of Statistics, University of Kentucky, Lexington, KY, USA.
Ahmed Abdel-Latif, Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA.
Khaled M. Ziada, Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Angiology

Abstract

Bleeding is a major complication in patients presenting with ST-segment elevation myocardial infarction (STEMI). Several studies suggested that Asians are more susceptible to bleeding when treated with antiplatelets, anticoagulants, and thrombolytic agents. In our study, we aimed to investigate the association between Asian ethnicity and bleeding events in patients who presented with STEMI. We analyzed the Nationwide Inpatient Sample database from 2002 to 2013 and identified patients hospitalized with a primary diagnosis of STEMI. We compared clinical outcomes between patients of Asian and white ethnicity. Primary outcome was inhospital major bleeding defined as a composite of intracranial hemorrhage and blood transfusions for bleeding events. After exclusions, an estimated 1 695 680 white and 46 563 Asian patients with STEMI were included in the analysis. Asian patients had a higher incidence of inhospital major bleeding (3.6% vs 2.2%, P < .001) without a significant difference in inhospital mortality (9.3% vs 8.7%, P = .06). Asian ethnicity was an independent predictor for major bleeding (estimated odds ratio: 1.32; 95% confidence interval: 1.16-1.51; P < .001). This increased risk of bleeding would warrant further investigation of optimal treatment strategies tailored for patients with STEMI of Asian ethnicity.

First Page

548

Last Page

554

DOI

10.1177/0003319717730168

Volume

69

Issue

6

Publication Date

7-1-2018

Medical Subject Headings

Aged; Asians (statistics & numerical data); Databases, Factual; Female; Fibrinolytic Agents (therapeutic use); Hemorrhage (ethnology); Hospital Mortality; Hospitalization (statistics & numerical data); Humans; Male; Middle Aged; Retrospective Studies; ST Elevation Myocardial Infarction (complications, ethnology, therapy); United States; Whites (statistics & numerical data)

PubMed ID

28905638

Recommended Citation

Misumida, N., Ogunbayo, G. O., Kim, S. M., Olorunfemi, O., Elbadawi, A., Charnigo, R. J., Abdel-Latif, A., & Ziada, K. M. (2018). Higher Risk of Bleeding in Asians Presenting With ST-Segment Elevation Myocardial Infarction: Analysis of the National Inpatient Sample Database. Angiology, 69 (6), 548-554. https://doi.org/10.1177/0003319717730168