Abstract WE475: Racial Disparities in In-Hospital Mortality Among Acute Myocardial Infarction Patients

Abstract

Background: Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality in the United States. Prior studies suggest that Asian/Pacific Islander (API) patients may face disproportionately higher hospitalization and mortality rates following AMI. Despite being the fastest-growing racial group in the U.S., APIs remain underrepresented in cardiovascular outcomes research. This study aimed to evaluate racial disparities in in-hospital mortality among patients hospitalized for AMI. Methods: We performed a retrospective analysis using data from the National Inpatient Sample (2016-2021) to identify adult patients hospitalized with a primary diagnosis of AMI (ICD-10-CM codes I21.0-I21.4). Study outcomes included rates of AMI hospitalization, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and in-hospital mortality, stratified by race/ethnicity and AMI type (STEMI vs NSTEMI). Weighted multivariable logistic regression models were used to examine the associations between race/ethnicity and each of the study outcomes, adjusting for demographic, hospital, socioeconomic, and clinical factors. Non-Hispanic Whites (NHWs) served as the reference group. Results: From 2016-2021, API patients experienced higher in-hospital mortality after AMI (5.7%) compared with NHW patients (4.7%). After full adjustment, APIs had significantly higher odds of in-hospital mortality for overall AMI (OR 1.19, 95% CI 1.12-1.27), STEMI (OR 1.46, 95% CI 1.19-1.79), and NSTEMI (OR 1.14, 95% CI 1.04-1.25). In contrast, Non-Hispanic Black and Hispanic patients had similar or lower adjusted mortality odds than NHWs. APIs demonstrated higher rates of CABG, which may partly account for the observed differences in mortality between APIs and other racial and ethnic groups. Conclusion: API patients experience higher in-hospital mortality following AMI, even after adjustment for clinical, demographic, and socioeconomic factors. These findings highlight the need for targeted, culturally informed interventions and further research to better understand this underrecognized health disparity.