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. 2017 Mar;130(3):317-327.
doi: 10.1016/j.amjmed.2016.09.014. Epub 2016 Oct 14.

Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN)

Kristi Reynolds  1 , Alan S Go  2 , Thomas K Leong  3 , Denise M Boudreau  4 , Andrea E Cassidy-Bushrow  5 , Stephen P Fortmann  6 , Robert J Goldberg  7 , Jerry H Gurwitz  8 , David J Magid  9 , Karen L Margolis  10 , Catherine J McNeal  11 , Katherine M Newton  4 , Rachel Novotny  12 , Charles P Quesenberry Jr  3 , Wayne D Rosamond  13 , David H Smith  6 , Jeffrey J VanWormer  14 , Suma Vupputuri  15 , Stephen C Waring  16 , Marc S Williams  17 , Stephen Sidney  3
Affiliations

Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN)

Kristi Reynolds et al. Am J Med. 2017 Mar.

Abstract

Background: Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations.

Methods: We examined trends in hospitalized acute myocardial infarction incidence among adults aged ≥25 years in 13 US health plans in the Cardiovascular Research Network. The first hospitalization per member for acute myocardial infarction overall and for ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction was identified by International Classification of Diseases, Ninth Revision, Clinical Modification primary discharge codes in each calendar year from 2000 through 2008. Age- and sex-adjusted incidence was calculated per 100,000 person-years using direct adjustment with 2000 US census data.

Results: Between 2000 and 2008, we identified 125,435 acute myocardial infarction hospitalizations. Age- and sex-adjusted incidence rates (per 100,000 person-years) of acute myocardial infarction decreased an average 3.8%/y from 230.5 in 2000 to 168.6 in 2008. Incidence of ST-segment elevation myocardial infarction decreased 8.7%/y from 104.3 in 2000 to 51.7 in 2008, whereas incidence of non-ST-segment elevation myocardial infarction increased from 126.1 to 129.4 between 2000 and 2004 and then decreased thereafter to 116.8 in 2008. Age- and sex-specific incidence rates generally reflected similar patterns, with relatively larger decreases in ST-segment elevation myocardial infarction rates in women compared with men. As compared with 2000, the age-adjusted incidence of ST-segment elevation myocardial infarction in 2008 was 48% lower among men and 61% lower among women.

Conclusions and relevance: Among a large, diverse, multicenter community-based insured population, there were significant decreases in incidence of hospitalized acute myocardial infarction and the more serious ST-segment elevation myocardial infarctions between 2000 and 2008. Decreases in ST-segment elevation myocardial infarctions were most pronounced among women. While ecologic in nature, these secular decreases likely reflect, at least in part, results of improvement in primary prevention efforts.

Keywords: Acute myocardial infarction; Cardiovascular disease; Epidemiology; Sex differences; Trends.

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Figures

Figure 1
Figure 1
Participating health care delivery systems in the Cardiovascular Research Network
Figure 2
Figure 2
Use of outpatient medications prior to index hospitalization with acute myocardial infarction from 7 health care delivery systems in the Cardiovascular Research Network, 2000–2008 The use of medications in patients presenting with any acute myocardial infarction in Panel A, ST-segment elevation myocardial infarction in Panel B, and non-ST-segment elevation myocardial infarction in Panel C. ACE = angiotensin-converting enzyme, and ARB = angiotensin II-receptor blocker
Figure 3
Figure 3
Age- and sex-adjusted incidence of acute myocardial infarction among health care delivery systems of the Cardiovascular Research Network, 2000–2008 Panel A includes data from 13 health care delivery systems and Panel B includes data from a subset of 7 health care delivery systems with data for all years of the study (p-value for trend <0.001 for all) formula image bars represent 95% confidence intervals.
Figure 4
Figure 4
Age-adjusted incidence of acute myocardial infarction by sex among 7 health care delivery systems of the Cardiovascular Research Network, 2000–2008 (p-value for trend <0.001 for all) Incidence among men in Panel A and women in Panel B. formula image bars represent 95% confidence intervals.
See this image and copyright information in PMC

References

    1. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2015 - PubMed
    1. Sidney S, Rosamond WD, Howard VJ, Luepker RV National Forum for Heart Disease Stroke Prevention. The “heart disease and stroke statistics--2013 update” and the need for a national cardiovascular surveillance system. Circulation. 2013;127(1):21–23. - PubMed
    1. Floyd KC, Yarzebski J, Spencer FA, et al. A 30-year perspective (1975–2005) into the changing landscape of patients hospitalized with initial acute myocardial infarction: Worcester Heart Attack Study. Circ Cardiovasc Qual Outcomes. 2009;2(2):88–95. - PMC - PubMed
    1. Parikh NI, Gona P, Larson MG, et al. Long-term trends in myocardial infarction incidence and case fatality in the National Heart, Lung, and Blood Institute’s Framingham Heart study. Circulation. 2009;119(9):1203–1210. - PMC - PubMed
    1. Roger VL, Weston SA, Gerber Y, et al. Trends in incidence, severity, and outcome of hospitalized myocardial infarction. Circulation. 2010;121(7):863–869. - PMC - PubMed