In the Journals

Risk for MI during pregnancy increased in US women

Sripal Bangalore, MD, MHA
Sripal Bangalore

In a new study that looked at outcomes of acute MI complicating pregnancy and the puerperium, acute MI occurred in about eight cases per 100,000 hospitalizations in pregnant women and in those up to 6 weeks after childbirth.

Additionally, “what we also found was in terms of mortality after an MI was that it remained steady over the last decade or so, despite the fact that we have significant advances in both medical management and device-based therapies for the treatment of [acute] MI,” Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, associate professor of medicine, director of research of the cardiac catheterization laboratory and director of the Cardiovascular Outcomes Group in the Cardiovascular Clinical Research Center at NYU Langone Health, told Cardiology Today. Bangalore is also a member of the Cardiology Today Next Gen Innovators.

Nathaniel R. Smilowitz, MD, interventional cardiologist and teaching assistant in the department of medicine at NYU Langone Health, together with Bangalore and colleagues analyzed data from 55,402,290 hospitalizations (mean age, 28 years) during pregnancy and the puerperium from the National Inpatient Sample database from 2002 to 2014.

The primary outcome of interest was in-hospital all-cause mortality.

Of the hospitalizations included in this study, 4,471 cases of acute MI occurred (8.1 cases per 100,000 hospitalizations; 95% CI, 7.5-8.6) during the antepartum period (20.6%), during labor and delivery (23.7%), and during the postpartum period (53.5%). Acute MIs were either STEMI (42.4%) or non-STEMI (57.6%).

Among women who had an acute MI during pregnancy, 25.1% underwent coronary revascularization and 53.1% underwent invasive management.

Women with acute MI during pregnancy had an increased risk for in-hospital mortality compared with those who did not have the event during pregnancy (adjusted OR = 39.9; 95% CI, 23.3-68.4).

Pregnant woman
Acute MI occurred in about eight cases per 100,000 hospitalizations in pregnant women and in those up to 6 weeks after childbirth.
Source: Shutterstock

The rate of acute MI during pregnancy and the puerperium increased from 2002 to 2014 (aOR = 1.25; 95% CI, 1.02-1.52).

“If you do have a pregnant patient who has a heart attack, we have to be careful and manage them appropriately so that we should do whatever we can to reduce that risk,” Bangalore said in an interview. – by Darlene Dobkowski

For more information:

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, can be reached at NYU School of Medicine, 550 First Ave., New York, NY 10016; email: sripalbangalore@gmail.com.

Disclosures: The authors report no relevant financial disclosures.

Sripal Bangalore, MD, MHA
Sripal Bangalore

In a new study that looked at outcomes of acute MI complicating pregnancy and the puerperium, acute MI occurred in about eight cases per 100,000 hospitalizations in pregnant women and in those up to 6 weeks after childbirth.

Additionally, “what we also found was in terms of mortality after an MI was that it remained steady over the last decade or so, despite the fact that we have significant advances in both medical management and device-based therapies for the treatment of [acute] MI,” Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, associate professor of medicine, director of research of the cardiac catheterization laboratory and director of the Cardiovascular Outcomes Group in the Cardiovascular Clinical Research Center at NYU Langone Health, told Cardiology Today. Bangalore is also a member of the Cardiology Today Next Gen Innovators.

Nathaniel R. Smilowitz, MD, interventional cardiologist and teaching assistant in the department of medicine at NYU Langone Health, together with Bangalore and colleagues analyzed data from 55,402,290 hospitalizations (mean age, 28 years) during pregnancy and the puerperium from the National Inpatient Sample database from 2002 to 2014.

The primary outcome of interest was in-hospital all-cause mortality.

Of the hospitalizations included in this study, 4,471 cases of acute MI occurred (8.1 cases per 100,000 hospitalizations; 95% CI, 7.5-8.6) during the antepartum period (20.6%), during labor and delivery (23.7%), and during the postpartum period (53.5%). Acute MIs were either STEMI (42.4%) or non-STEMI (57.6%).

Among women who had an acute MI during pregnancy, 25.1% underwent coronary revascularization and 53.1% underwent invasive management.

Women with acute MI during pregnancy had an increased risk for in-hospital mortality compared with those who did not have the event during pregnancy (adjusted OR = 39.9; 95% CI, 23.3-68.4).

Pregnant woman
Acute MI occurred in about eight cases per 100,000 hospitalizations in pregnant women and in those up to 6 weeks after childbirth.
Source: Shutterstock

The rate of acute MI during pregnancy and the puerperium increased from 2002 to 2014 (aOR = 1.25; 95% CI, 1.02-1.52).

“If you do have a pregnant patient who has a heart attack, we have to be careful and manage them appropriately so that we should do whatever we can to reduce that risk,” Bangalore said in an interview. – by Darlene Dobkowski

For more information:

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, can be reached at NYU School of Medicine, 550 First Ave., New York, NY 10016; email: sripalbangalore@gmail.com.

Disclosures: The authors report no relevant financial disclosures.

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