Literature DB >> 23168007

Population trends and inequalities in incidence and short-term outcome of acute myocardial infarction between 1998 and 2007.

Carla Koopman1, Michiel L Bots, Aloysia A M van Oeffelen, Ineke van Dis, W M Monique Verschuren, Peter M Engelfriet, Simon Capewell, Ilonca Vaartjes.   

Abstract

OBJECTIVE: We studied time trends in acute myocardial infarction (AMI) incidence, including out-of-hospital mortality proportions and hospitalized case-fatality rates. In addition, we compared AMI trends by age, gender and socioeconomic status.
METHODS: We linked the national Dutch hospital discharge register with the cause of death register to identify first AMI in patients ≥ 35 years between 1998 and 2007. Events were categorized in three groups: 178,322 hospitalized non-fatal, 43,210 hospitalized fatal within 28 days, and 75,520 out-of-hospital fatal AMI events. Time trends were analyzed using Joinpoint and Poisson regression.
RESULTS: Since 1998, age-standardized AMI incidence rates decreased from 620 to 380 per 100,000 in 2007 in men and from 323 to 210 per 100,000 in 2007 in women. Out-of-hospital mortality decreased from 24.3% of AMI in 1998 to 20.6% in 2007 in men and from 33.0% to 28.9% in women. Hospitalized case-fatality declined from 2003 onwards. The annual percentage change in incidence was larger in men than women (-4.9% vs. -4.2%, P<0.001). Furthermore, the decline in AMI incidence was smaller in young (35-54 years: -3.8%) and very old (≥ 85 years: -2.6%) men and women compared to middle-aged individuals (55-84 years: -5.3%, P<0.001). Smaller declines in AMI rates were observed in deprived socioeconomic quintiles Q5 and Q4 relative to the most affluent quintile Q1 (P=0.002 and P=0.015).
CONCLUSIONS: Substantial improvements were observed in incidence, out-of-hospital mortality and short-term case-fatality after AMI in the Netherlands. Young and female groups tend to fall behind, and socioeconomic inequalities in AMI incidence persisted and have not narrowed.
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Entities:  

Keywords:  Acute myocardial infarction; Coronary heart disease; Incidence; Inequalities; Socioeconomic status; Trends

Mesh:

Year:  2012        PMID: 23168007     DOI: 10.1016/j.ijcard.2012.10.036

Source DB:  PubMed          Journal:  Int J Cardiol        ISSN: 0167-5273            Impact factor:   4.164


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