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. 2012 Apr 17;125(15):1848-57.
doi: 10.1161/CIRCULATIONAHA.111.047480. Epub 2012 Mar 15.

Twenty-two-year trends in incidence of myocardial infarction, coronary heart disease mortality, and case fatality in 4 US communities, 1987-2008

Wayne D Rosamond  1 , Lloyd E Chambless, Gerardo Heiss, Thomas H Mosley, Josef Coresh, Eric Whitsel, Lynne Wagenknecht, Hanyu Ni, Aaron R Folsom
Affiliations

Twenty-two-year trends in incidence of myocardial infarction, coronary heart disease mortality, and case fatality in 4 US communities, 1987-2008

Wayne D Rosamond et al. Circulation. .

Abstract

Background: Knowledge of trends in the incidence of and survival after myocardial infarction (MI) in a community setting is important to understanding trends in coronary heart disease (CHD) mortality rates.

Methods and results: We estimated race- and gender-specific trends in the incidence of hospitalized MI, case fatality, and CHD mortality from community-wide surveillance and validation of hospital discharges and of in- and out-of-hospital deaths among 35- to 74-year-old residents of 4 communities in the Atherosclerosis Risk in Communities (ARIC) Study. Biomarker adjustment accounted for change from reliance on cardiac enzymes to widespread use of troponin measurements over time. During 1987-2008, a total of 30 985 fatal or nonfatal hospitalized acute MI events occurred. Rates of CHD death among persons without a history of MI fell an average 4.7%/y among men and 4.3%/y among women. Rates of both in- and out-of-hospital CHD death declined significantly throughout the period. Age- and biomarker-adjusted average annual rate of incident MI decreased 4.3% among white men, 3.8% among white women, 3.4% among black women, and 1.5% among black men. Declines in CHD mortality and MI incidence were greater in the second decade (1997-2008). Failure to account for biomarker shift would have masked declines in incidence, particularly among blacks. Age-adjusted 28-day case fatality after hospitalized MI declined 3.5%/y among white men, 3.6%/y among black men, 3.0%/y among white women, and 2.6%/y among black women.

Conclusions: Although these findings from 4 communities may not be directly generalizable to blacks and whites in the entire United States, we observed significant declines in MI incidence, primarily as a result of downward trends in rates between 1997 and 2008.

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Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
Age- and biomarker-adjusted rate (per 1000 persons) in first hospitalized myocardial infarction or death due to CHD without prior myocardial infarction, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 1
Figure 1
Age- and biomarker-adjusted rate (per 1000 persons) in first hospitalized myocardial infarction or death due to CHD without prior myocardial infarction, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 1
Figure 1
Age- and biomarker-adjusted rate (per 1000 persons) in first hospitalized myocardial infarction or death due to CHD without prior myocardial infarction, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 1
Figure 1
Age- and biomarker-adjusted rate (per 1000 persons) in first hospitalized myocardial infarction or death due to CHD without prior myocardial infarction, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 2
Figure 2
Age-adjusted 28-day case fatality percentage for hospitalized MI events, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 2
Figure 2
Age-adjusted 28-day case fatality percentage for hospitalized MI events, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 2
Figure 2
Age-adjusted 28-day case fatality percentage for hospitalized MI events, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
Figure 2
Figure 2
Age-adjusted 28-day case fatality percentage for hospitalized MI events, and age-adjusted trends by linear or quadratic Poisson regression, men and women 35 to 74 years of age, the ARIC Study 1987 through 2008.
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References

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