Aim The focus on age-adjusted data might conceal the complex relation of sex differences at specific ages. In this study, we aim to examine sex-specific hospitalization rates (HRs) of Acute Myocardial Infarction (AMI) in the following age groups: 0-64 years-old and 65 or older. Methods We conducted a retrospective, population-based analysis of all hospital discharge records from 2000 to 2024 in the Veneto. Sex-specific AMI HRs were estimated according to age group and expressed per 100,000 population. The Average Annual Percentage Change (AAPC) and relative 95% Confidence Intervals (CIs) were calculated to identify trends. Results From 2000 to 2024, 167,277 patients were hospitalized for AMI in the Veneto Region (mean age: 71.4 ± 13.5 years, 64.3% males). The annual incidence of AMI hospitalizations decreased in the study period among Veneto residents aged 65 or older, both in males [from 744 to 478 per 100,000 population; AAPC –2.21% (95% CI: –2.50 to –1.93), p<0.0001] and in females [from 423 to 221 per 100,000 population; AAPC –3.30% (95% CI: –3.77 to –2.87), p<0.0001]. By contrast, a declining incidence of AMI hospitalizations was not observed for residents aged 0 to 64, neither among males [from 83 to 90 per 100,000 population; AAPC +0.09% (95% CI: –0.21 to +0.39), p=0.5299] nor among females [from 17 to 20 per 100,000 population; AAPC +0.21% (95% CI: –0.25 to + 0.68), p=0.3355] ( Figure 1 ). Population aging was evident in both sexes during the study period in the Veneto Region, with the percentage of Veneto residents aged 0 to 64 declining over time relative to the entire Veneto population ( Figure 2 ). However, the annual proportion of AMI admissions attributable to 0-64 patients was steady among males (nearly 40% in each calendar year) and even increasing among females, from 13% in 2000 to 20% in 2024 ( Figure 3 ). Conclusions Hospitalizations for AMI decreased in the Veneto Region from 2000 to 2024 among population aged 65 or older, but not among the younger group. Despite aging population, the proportion of AMI hospitalizations attributable to young patients increased from 2000 to 2024 in the Veneto Region among females, but not among males.


