Outcomes of Acute Myocardial Infarction in Patients with Familial Hypercholesteremia.

Abstract

BACKGROUND\nThere is a paucity of contemporary data regarding the outcomes of acute myocardial infarction among patients with familial hypercholesteremia.\n\n\nMETHODS\nWe 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.\n\n\nRESULTS\nThe analysis included 1,363,488 hospitalizations with acute myocardial infarction. The prevalence of familial hypercholesteremia was 0.07% among acute myocardial infarction admissions. Compared to 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 versus without familial hypercholesteremia (adjusted-OR 0.76; 95% 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 (adjusted-OR 0.75; 95% CI 0.51-1.10) or 30-day readmission for AMI. However, a non-significant trend towards higher readmission for PCI was observed among patients with familial hypercholesteremia (adjusted-OR 1.89; 95% CI 0.98-3.64).\n\n\nCONCLUSION\nIn 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 to those without familial hypercholesteremia.