Table 1. Baseline characteristics stratified according to multimorbidity phenotype cluster at the time of acute myocardial infarction hospitalisation, 2003–2013 (prior to multiple imputation for missing data).
| Variable | Measure | Total cohort, N = 693,388 | Multimorbidity phenotype cluster1 | P-value2 | Missing (%)3 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Class 1 N = 47,839 |
Class 2 N = 87,009 |
Class 3 N = 433,215 |
Total cohort | Class 1 | Class 2 | Class 3 | ||||
| Age (years)4 | Median (IQR) | 70.7 (59.4–80.1) | 78.9 (71–84.8) | 74 (64.8–81.3) | 68.5 (57.5–79.0) | <0.001 | 0.1 | 0.1 | 0.1 | 0.1 |
| Sex (male)5 | N (%) | 452,896 (65.5) | 28,613 (59.9) | 53,412 (61.5) | 288,948 (66.9) | <0.001 | 0.3 | 0.1 | 0.2 | 0.2 |
| Year of admission6 | <0.001 | 0 | 0 | 0 | 0 | |||||
| 2003–2006 | N (%) | 244,499 (35.3) | 14,040 (7.9) | 24,764 (13.9) | 139,769 (78.3) | |||||
| 2007–2010 | N (%) | 274,085 (39.5) | 19,748 (8.5) | 36,458 (15.6) | 177,605 (76.0) | |||||
| 2011–2013 | N (%) | 174,804 (25.2) | 14,051 (9.0) | 25,787 (16.6) | 115,841 (74.4) | |||||
| Index of multiple deprivation5 | Median (IQR) | 18.3 (10.6 to 31.8) | 19.4 (11.3–33.5) | 19.5 (11.2–33.7) | 17.7 (10.3–30.6) | <0.001 | 8.2 | 7.9 | 7.5 | 8.0 |
| GRACE risk score7 | <0.001 | 56.0 | 45.6 | 46.6 | 50.5 | |||||
| <70 | N (%) | 21,686 (7.1) | 258 (1.0) | 1,707 (3.7) | 18,606 (8.7) | |||||
| 70–87 | N (%) | 33,539 (11.0) | 576 (2.2) | 3,539 (7.6) | 27,785 (13.0) | |||||
| ≥88 | N (%) | 249,892 (81.9) | 25,187 (96.8) | 41,231 (88.7) | 167,975 (78.4) | |||||
| Index AMI STEMI(versus NSTEMI) | N (%) | 274,220 (39.5) | 8,019 (16.8) | 24,721 (28.4) | 183,601 (42.4) | <0.001 | 0 | 0 | 0 | 0 |
| SBP (mm Hg)4 | Mean (SD) | 139.2 (29) | 137.1 (30.6) | 142.2 (29.9) | 138.9 (28.4) | <0.001 | 19.3 | 10.3 | 10.5 | 11.3 |
| Heart rate (beat/min)4 | Mean (SD) | 81.9 (23.2) | 88.3 (24.6) | 84.4 (23.2) | 80.6 (22.6) | <0.001 | 19 | 10.1 | 10.3 | 10.9 |
| Total cholesterol (mmol/l)8 | Median (IQR) | 5.0 (1.4) | 4.2 (1.4) | 4.4 (1.4) | 5.2 (1.4) | <0.001 | 35.7 | 48.6 | 39.0 | 32.0 |
| Creatinine (μmol/l) | Median (IQR) | 91.0 (76.0–112.0) | 131.0 (98.0–188.0) | 97.0 (79.0–124.0) | 88.0 (74.0–105.0) | <0.001 | 44.5 | 35.5 | 35.4 | 39.1 |
| Medical history5 | ||||||||||
| Current or ex-smoker | N (%) | 390,956 (62.2) | 26,406 (60.6) | 48,858 (59.9) | 262,649 (64.0) | <0.001 | 9.4 | 8.9 | 6.2 | 5.2 |
| Family history of coronary heart disease | N (%) | 140,388 (32.7) | 6,358 (21.1) | 18,338 (30.0) | 104,220 (33.8) | <0.001 | 38.2 | 37.0 | 29.6 | 28.8 |
| Previous AMI | N (%) | 136,482 (21.9) | 20,620 (43.5) | 25,791 (29.8) | 74,360 (17.2) | <0.001 | 10.1 | 0.9 | 0.5 | 0.3 |
| Previous angina | N (%) | 169,454 (27.5) | 23,547 (49.7) | 33,206 (38.4) | 94,389 (21.9) | <0.001 | 11.2 | 1.0 | 0.7 | 0.4 |
| Admission treatment5 | ||||||||||
| Revascularisation9 | N (%) | 227,275 (42.1) | 5,238 (14.8) | 18,149 (26.9) | 145,951 (42.7) | <0.001 | 22.2 | 26.2 | 22.5 | 21.1 |
| Loop diuretic | N (%) | 155,674 (28.1) | 27,894 (62.9) | 29,265 (36.8) | 85,848 (22.0) | <0.001 | 20.1 | 7.3 | 8.7 | 10.0 |
| Discharge medication5 | ||||||||||
| Aspirin | N (%) | 510,387 (85.7) | 31,780 (83.8) | 6,384 (87.3) | 329,292 (87.2) | <0.001 | 9.5 | 20.7 | 15.9 | 12.8 |
| β-blocker | N (%) | 427,191 (79.1) | 23,443 (74.0) | 54,013 (80.9) | 280,719 (81.4) | <0.001 | 10.3 | 33.8 | 23.3 | 20.4 |
| Statin | N (%) | 503,686 (83.4) | 31,718 (80.6) | 64,379 (85.9) | 324,934 (85.2) | <0.001 | 10.1 | 17.7 | 13.9 | 11.9 |
| ACEi or ARB | N (%) | 442,954 (77.5) | 25,175 (74.7) | 56,717 (80.6) | 289,225 (79.4) | <0.001 | 10.7 | 29.5 | 19.1 | 15.9 |
| P2Y12 inhibitor | N (%) | 217,539 (94.4) | 14,854 (94.9) | 30,730 (95.0) | 147,771 (94.8) | 0.264 | 56.2 | 67.3 | 62.8 | 64.0 |
| Aldosterone antagonist | N (%) | 17,035 (10.3) | 2,826 (21.8) | 2,655 (11.1) | 9,825 (8.8) | <0.001 | 60.0 | 72.9 | 72.6 | 74.1 |
| Mortality (unadjusted) | ||||||||||
| 30 days | N (%) | 62,950 (9.1) | 8,139 (17.0) | 8,656 (10.0) | 32,002 (7.4) | <0.001 | 0 | 0 | 0 | 0 |
| 1 year | N (%) | 102,254 (14.8) | 19,025 (39.8) | 18,600 (21.4) | 62,151 (14.4) | <0.001 | 0 | 0 | 0 | 0 |
| 5 years | N (%) | 204,667 (29.5) | 27,471 (57.4) | 29,537 (34.0) | 97,161 (22.4) | <0.001 | 0 | 0 | 0 | 0 |
1Class 1 characterises patients with high multimorbidity, especially with concomitant chronic heart failure, peripheral vascular disease, and hypertension. Class 2 characterises patients with medium multimorbidity, especially peripheral vascular disease and hypertension. Class 3 characterises patients with low multimorbidity but with peripheral vascular disease.
2P-value for difference between classes.
3S6 Table contains patient characteristics for those with missing latent class data (prior to multiple imputation for missing data).
4Values are means and standard deviations, and P-values are derived from t tests.
5Values are numbers and percentages, and P-values are derived from chi-squared tests.
6Column percentages shown to highlight temporal trend.
7Given international guidelines, Global Registry of Acute Coronary Events (GRACE) risk score was categorised into lowest (<70), low (70 to 87), and intermediate-to-high risk (≥88).
8Values are medians and interquartile ranges, and P-values are derived from Wilcoxon rank-sum tests.
9Thrombolysis or coronary intervention (percutaneous coronary intervention or coronary artery bypass graft surgery) or both.
ACEi, angiotensin-converting enzyme inhibitor; AMI, acute myocardial infarction; ARB, angiotensin receptor blocker; NSTEMI, non-ST-elevated myocardial infarction; SBP, systolic blood pressure; STEMI, ST-elevated myocardial infarction.