{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:31:04Z","timestamp":1789785064630,"version":"4.0.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,11,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pregnancy increases the risk of acute myocardial infarction (AMI). The purpose of this study was to examine timing and risk factors for AMI in pregnancy and poor outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              National Inpatient Sample (2003\u20132015) was screened in pregnancy, labor and delivery, and postpartum. There were 11\u00a0297\u00a0849 records extracted with 913 instances of AMI (0.008%). One hundred eleven (12.2%) women experienced AMI during labor and delivery, 338 (37.0%) during pregnancy and most during the postpartum period (464; 50.8%). The prevalence of AMI in pregnancy has increased (\n              <jats:italic>P<\/jats:italic>\n              =0.0005). Most major adverse cardiovascular and cerebrovascular events occurred in the postpartum period (63.5%). Inpatient mortality was 4.5%. Predictors of AMI include known coronary artery disease (odds ratio [OR], 517.4; 95% CI, 420.8\u2013636.2), heart failure (OR, 8.2; 95% CI, 1.9\u201335.2), prior valve replacement (OR, 6.4; 95% CI, 2.4\u201317.1), and atrial fibrillation (OR, 2.7; CI, 1.5\u20134.7;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Risk factors of traditional atherosclerosis including hyperlipidemia, obesity, tobacco history, substance abuse, and thrombophilia were identified (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Gestational hypertensive disorders (eclampsia OR, 6.0; 95% CI, 3.3\u201310.8; preeclampsia OR, 3.2; 95% CI, 2.5\u20134.2) were significant risk factors in predicting AMI. Risk factors associated with major adverse cardiovascular and cerebrovascular events included prior percutaneous coronary intervention (OR, 6.6; 95% CI, 1.4\u201331.2) and pre\u2010eclampsia (OR, 2.3; 95% CI, 1.3\u20133.9).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">AMI is associated with modifiable, nonmodifiable, and obstetric risk factors. These risk factors can lead to devastating adverse outcomes and highlight the need for risk factor modification and public health resource initiatives toward the goal of decreasing AMI in the pregnant population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016623","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T09:00:42Z","timestamp":1603789242000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Risk Factors and Timing of Acute Myocardial Infarction Associated With Pregnancy: Insights From the National Inpatient Sample"],"prefix":"10.1161","volume":"9","author":[{"given":"Courtney A.","family":"Balgobin","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine State University of New York Stony Brook University Medical Center Renaissance School of Medicine Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Family, Population and Preventative Medicine Stony Brook University Medical Center Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio V.","family":"Lima","sequence":"additional","affiliation":[{"name":"Division of Cardiology Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Avila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine Stony Brook University Medical Center Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puja B.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine State University of New York Stony Brook University Medical Center Renaissance School of Medicine Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Family, Population and Preventative Medicine Stony Brook University Medical Center Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-9029","authenticated-orcid":false,"given":"Kathleen","family":"Stergiopoulos","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine State University of New York Stony Brook University Medical Center Renaissance School of Medicine Stony Brook NY"},{"name":"St. Francis Hospital \u2013 The Heart Center\u00ae Roslyn NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","unstructured":"Centers for Disease Control and Prevention . Pregnancy mortality surveillance system. 2019. Available at: http:\/\/www.cdc.gov\/repro\u200bducti\u200bvehea\u200blth\/Mater\u200bnalIn\u200bfantH\u200bealth\/\u200bPMSS.html. Accessed February 19 2020."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcw060"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.576751"},{"key":"e_1_3_2_5_2","first-page":"139","article-title":"Myocardial infarction during pregnancy: a review","volume":"65","author":"Hankins GD","year":"1985","unstructured":"Hankins GD, Wendel GD Jr, Leveno KJ, Stoneham J. Myocardial infarction during pregnancy: a review. 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Nationwide Inpatient Sample (NIS). Available at: https:\/\/www.hcup\u2010us.ahrq.gov\/nisov\u200berview.jsp. Accessed February 19 2020."},{"key":"e_1_3_2_14_2","article-title":"Getting the most out of the SAS survey procedures: repeated replication methods, subpopulation analysis, and missing data options in SAS v9. 2","author":"Berglund PA","year":"2009","unstructured":"Berglund PA. Getting the most out of the SAS survey procedures: repeated replication methods, subpopulation analysis, and missing data options in SAS v9. 2. SAS Glob Forum. 2009. 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