{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:12:06Z","timestamp":1787026326760,"version":"build-2736575974"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate the incidence and outcomes of acute high-risk chest pain diseases, including acute myocardial infarction (AMI), aortic dissection (AD), and pulmonary embolism (PE) during pregnancy and puerperium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Inpatient Sample was queried to identify pregnancy-related hospitalizations from January 1, 2008 to December 31, 2017. Temporal trends in the incidence and mortality of AMI, AD and PE were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 41,174,101 hospitalizations, acute high-risk chest pain diseases were diagnosed in 40,285 (0.098%). The incidence increased from 79.92\/100,000 in 2008 to 114.79\/100,000 in 2017 (P\n                      <jats:sub>trend<\/jats:sub>\n                      &amp;lt; 0.0001). The most frequent was PE (86.5%), followed by AMI (9.6%) and AD (3.3%). The incidence of PE in pregnancy decreased after 2014 and was lower than AMI and AD, while its incidence in puerperium was higher than AMI and AD consistently (P\n                      <jats:sub>trend<\/jats:sub>\n                      &amp;lt; 0.0001). Subgroup analysis showed the incidence of these diseases was higher in black women, lowest-income households, and elderly parturients (P\n                      <jats:sub>trend<\/jats:sub>\n                      &amp;lt; 0.0001). The mortality decreased from 2.24% in 2008 to 2.21% in 2017 (P\n                      <jats:sub>trend<\/jats:sub>\n                      = 0.0240), exhibiting 200-fold higher than patients without these diseases. The following factors were significantly associated with these diseases: aged \u2265 45 years (OR, 4.25; 95%CI, 3.80\u20134.75), valvular disease (OR, 10.20; 95%CI, 9.73\u201310.70), and metastatic cancer (OR, 9.75; 95%CI, 7.78\u201312.22). The trend of elderly parturients increased from 14.94% in 2008 to 17.81% in 2017 (P\n                      <jats:sub>trend<\/jats:sub>\n                      &amp;lt; 0.0001), while no such up-trend was found in valvular disease and metastatic cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of acute high-risk chest pain diseases, especially PE in puerperium, increased consistently. Although mortality has shown a downward trend, it is still at a high level. We should strengthen monitoring and management of acute high-risk pain diseases in pregnancy and puerperium, especially for black women, lowest-income households, and elderly parturients in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2022.968964","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T04:25:56Z","timestamp":1660191956000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence and outcomes of acute high-risk chest pain diseases during pregnancy and 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