In-hospital outcomes of acute myocardial infarction in Asian Pacific Islanders in the United States over the past two decades: a propensity score–matched analysis

Background Asian Pacific Islanders (APIs) represent one of the fastest-growing racial and ethnic groups in the United States. Yet, national data on temporal trends and in-hospital outcomes of acute myocardial infarction (AMI) in this population remain limited.Methods Using the National Inpatient Sample, we conducted a retrospective analysis of AMI hospitalizations from 2003 to 2022. Hospitalizations were stratified into two groups based on race/ethnicity: APIs and non-APIs. Propensity score matching was used to match both study groups, and in-hospital outcomes were then analyzed.Results Compared to non-APIs, APIs experienced a higher proportion of cardiac arrest, cardiogenic shock, mechanical circulatory support use, respiratory failure, renal replacement therapy, stroke, clinically significant bleeding, and major adverse cardiac and cerebrovascular events (P < 0.001). APIs also experienced significantly higher in-hospital mortality when compared to non-APIs (P < 0.001). From 2003 to 2022, APIs consistently had higher in-hospital mortality compared to non-APIs.Conclusion APIs have significantly worse in-hospital outcomes and mortality compared to non-APIs when admitted for AMI, underscoring the need for targeted interventions to improve cardiovascular care in this population.