Time trend and age-period-cohort effects on acute myocardial infarction mortality in Korean adults from 1988 to 2007

Abstract

We examined time trend and age-period-cohort effects on acute myocardial infarction (AMI) mortality in Korean adults from 1988 to 2007. Annual AMI mortality data and population statistics from 1988 to 2007 were obtained from the STATISTICS KOREA website. Age adjusted mortality for four 5-yr calendar periods (1988-1992 to 2003-2007) was calculated by direct standardization using the Year 2000 WHO world standard population. A log-linear Poisson regression model was used to estimate age, period, and cohort effects on AMI mortality. In both genders, age-adjusted AMI mortality increased from period one (1988-1992) to period three (1998-2002) but decreased in period four (2003-2007). An exponential age effect was noted in both genders. The rate ratio of the cohort effect increased up to the 1943 birth cohort and decreased gradually thereafter, and the rate ratio of the period effect increased up to period three (1998-2002) and decreased thereafter. Our results suggest that AMI mortality in Korean adults has decreased since the period 1998-2002 and age, period, and cohort effects have influenced on AMI mortality.

Keywords: Mortality; Myocardial infarction; Trends.

Fig. 1

Age-specific mortality rates for acute myocardial infarction in Korean men (A) and women (B) on a natural logarithmic scale against birth year from 1988 to 2007.

Fig. 2

Estimates (solid line) of age, birth cohort, and period effects on acute myocardial infarction mortality in Korean men (A, B) and women (C, D) with 95% confidence intervals (dashed line). Age effects are expressed as rate ratios relative to age 50-54 yr, cohort effects are expressed as rate ratios relative to the 1948 and 1953 birth cohorts, and period effects are expressed as rate ratios relative to the period 1998-2002.