Document Detail

Population trends in the incidence and outcomes of acute myocardial infarction.
MedLine Citation:
PMID:  20558366     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Few studies have characterized recent population trends in the incidence and outcomes of myocardial infarction. METHODS: We identified patients 30 years of age or older in a large, diverse, community-based population who were hospitalized for incident myocardial infarction between 1999 and 2008. Age- and sex-adjusted incidence rates were calculated for myocardial infarction overall and separately for ST-segment elevation and non-ST-segment elevation myocardial infarction. Patient characteristics, outpatient medications, and cardiac biomarker levels during hospitalization were identified from health plan databases, and 30-day mortality was ascertained from administrative databases, state death data, and Social Security Administration files. RESULTS: We identified 46,086 hospitalizations for myocardial infarctions during 18,691,131 person-years of follow-up from 1999 to 2008. The age- and sex-adjusted incidence of myocardial infarction increased from 274 cases per 100,000 person-years in 1999 to 287 cases per 100,000 person-years in 2000, and it decreased each year thereafter, to 208 cases per 100,000 person-years in 2008, representing a 24% relative decrease over the study period. The age- and sex-adjusted incidence of ST-segment elevation myocardial infarction decreased throughout the study period (from 133 cases per 100,000 person-years in 1999 to 50 cases per 100,000 person-years in 2008, P<0.001 for linear trend). Thirty-day mortality was significantly lower in 2008 than in 1999 (adjusted odds ratio, 0.76; 95% confidence interval, 0.65 to 0.89). CONCLUSIONS: Within a large community-based population, the incidence of myocardial infarction decreased significantly after 2000, and the incidence of ST-segment elevation myocardial infarction decreased markedly after 1999. Reductions in short-term case fatality rates for myocardial infarction appear to be driven, in part, by a decrease in the incidence of ST-segment elevation myocardial infarction and a lower rate of death after non-ST-segment elevation myocardial infarction.
Robert W Yeh; Stephen Sidney; Malini Chandra; Michael Sorel; Joseph V Selby; Alan S Go
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  362     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-06-22     Revised Date:  2010-08-30    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2155-65     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Massachusetts Medical Society.
Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
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MeSH Terms
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary
Biological Markers / blood
Cardiovascular Agents / therapeutic use
Cohort Studies
Coronary Artery Bypass
Hospitalization / trends
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Middle Aged
Mortality / trends
Myocardial Infarction / blood,  epidemiology*,  mortality*,  therapy
Outcome Assessment (Health Care)*
United States / epidemiology
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comment In:
Nat Rev Cardiol. 2010 Sep;7(9):477

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