Key result
Primary-position AMI discharge claims fall ~13 percentage points from 1993 to 2008 as secondary claims rise.
Cohort
Yes
The prevalence of AMI, particularly NSTEMI, has increased among dialysis patients, with a shift towards secondary diagnosis claims, highlighting a growing high-risk population.
May indicate rising secondary AMI burden in dialysis patients; leaves open whether incidence or coding practices drive the shift.
Analysis of a contemporary cohort of patients on dialysis revealed that mortality from acute myocardial infarction (AMI) has decreased, whereas the prevalence of AMI has increased markedly, particularly among patients with non-ST elevation myocardial infarction (NSTEMI). Using inpatient discharge diagnosis codes (1993-2008), we determined that proportions of AMI claims decreased in the primary position (from 65% to 52%) but increased in the secondary position (from 35% to 48%). Proportions of NSTEMI codes increased remarkably in both the primary and secondary positions. The progressive increase in diagnostic claims for secondary AMI identifies a unique high-risk population and has important clinical, economic, and epidemiologic implications among patients on dialysis.
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Shroff et al. (2017) conducted a cohort in Acute Myocardial Infarction. Hospital admission year 2008 vs. Hospital admission year 1993 was evaluated on Proportion of acute myocardial infarction claims in the primary position. Between 1993 and 2008, the proportion of acute myocardial infarction discharge claims in the primary position decreased from 65% to 52%, while those in the secondary position increased from 35% to 48%.
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