Multimorbidity Patterns and In-Hospital Outcomes in Chinese Young Women (Aged <55 Years) Presenting with ST-Segment-Elevation Myocardial Infarction.

Abstract

Background: Recent evidence highlights an increasing incidence of myocardial infarction in young women. Identifying clinical multimorbidity patterns in this population may improve therapeutic strategies and clinical care.

Methods and results: We identified multimorbidity patterns in 9570 young women with ST-segment-elevation myocardial infarction (median age, 50 years [range, 47.0-53.0 years]) admitted to the China Chest Pain Center Database between 2016 and 2021. Hierarchical clustering of 15 medical conditions was performed to derive multimorbidity patterns. The primary outcome was a composite of in-hospital adverse events. Associations between multimorbidity patterns and outcomes were evaluated using multivariable-adjusted logistic regression models. Among 9570 patients, 50% (n=4789) had multimorbidity. Six multimorbidity patterns were identified, including 4 specific patterns: (1) pattern 1, cerebrovascular cluster (histories of cerebrovascular disease and hypertension); (2) pattern 2, traditional cardiovascular disease risk factors cluster (histories of hyperlipidemia, obesity, and diabetes, and family history of cardiovascular disease and smoking); (3) pattern 3, coronary-heart failure cluster (histories of heart failure, coronary artery disease, peripheral arterial disease, and thyroid dysfunction); and (4) pattern 4, anemia-renal dysfunction cluster (histories of atrial fibrillation, anemia, chronic kidney disease, and peptic ulcer). Compared with patients without multimorbidity, those with pattern 1 (odds ratio [OR], 2.29 [95% CI, 1.49-3.52]), pattern 2 (OR, 1.52 [95% CI, 1.24-1.86]), and pattern 4 (OR, 2.25 [95% CI, 1.10-4.61]) exhibited higher risks for composite outcomes.

Conclusions: Specific multimorbidity patterns in young women with ST-segment-elevation myocardial infarction were associated with distinct in-hospital outcomes in a nationwide registry, providing proof-of-concept evidence to guide future therapeutic approaches.