| Population trends in the incidence and outcomes of acute myocardial infarction. | |
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MedLine Citation:
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PMID: 20558366 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Robert W Yeh; Stephen Sidney; Malini Chandra; Michael Sorel; Joseph V Selby; Alan S Go |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The New England journal of medicine Volume: 362 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-18 Completed Date: 2010-06-22 Revised Date: 2010-08-30 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
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Languages: eng Pagination: 2155-65 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Massachusetts Medical Society. |
Affiliation:
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Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary Biological Markers / blood Cardiovascular Agents / therapeutic use Cohort Studies Coronary Artery Bypass Electrocardiography Female Hospitalization / trends Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Incidence Male Middle Aged Mortality / trends Myocardial Infarction / blood, epidemiology*, mortality*, therapy Outcome Assessment (Health Care)* United States / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Cardiovascular Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| Comments/Corrections | |
Comment In:
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Nat Rev Cardiol. 2010 Sep;7(9):477 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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