Todd M Brown1, Luqin Deng2, David J Becker2, Vera Bittner3, Emily B Levitan2, Robert S Rosenson4, Monika M Safford3, Paul Muntner2. 1. School of Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: tmbrown@uab.edu. 2. School of Public Health, University of Alabama at Birmingham, Birmingham, AL. 3. School of Medicine, University of Alabama at Birmingham, Birmingham, AL. 4. Icahn School of Medicine at Mount Sinai, New York, NY.
Abstract
BACKGROUND: Few contemporary studies examine trends in recurrent coronary heart disease (CHD) events and mortality after acute myocardial infarction (AMI) and whether these trends vary by race or sex. METHODS: We used data from the national 5% random sample of Medicare fee-for-service beneficiaries for 1999 to 2010. We included beneficiaries who experienced an AMI (International Classification of Disease [ICD] 9 410.xx, except 410.x2) between January 1, 2001, and December 31, 2009. Each beneficiary's first AMI was included as their index event. Outcomes included all-cause mortality, recurrent AMI, and recurrent CHD events during the 365days after discharge for the index AMI. To examine secular trends, we pooled calendar years into 3 periods (2001-2003, 2004-2006, and 2007-2009). RESULTS: Among 48,688 beneficiaries with index AMIs from 2001 to 2009, we observed decreases in the age-adjusted rates for mortality (-3.8% for each 3-year period, 95% CI -6.1% to -1.6%, P trend = .001), recurrent AMI (-15.0%, 95% CI -18.6% to -11.2%, P trend < .001), and recurrent CHD events (-11.1%, 95% CI -14.0% to -8.0%, P trend < .001) in the 365days after the index AMI. In 2007 to 2009, blacks had excess risk relative to whites for mortality and recurrent AMI (black/white incidence rate ratio of 1.38 for mortality [95% CI 1.21-1.57] and 1.38 for recurrent AMI [95% CI 1.07-1.79]). CONCLUSIONS: Despite overall favorable trends in lower mortality and recurrent events after AMI, efforts are needed to reduce racial disparities.
BACKGROUND: Few contemporary studies examine trends in recurrent coronary heart disease (CHD) events and mortality after acute myocardial infarction (AMI) and whether these trends vary by race or sex. METHODS: We used data from the national 5% random sample of Medicare fee-for-service beneficiaries for 1999 to 2010. We included beneficiaries who experienced an AMI (International Classification of Disease [ICD] 9 410.xx, except 410.x2) between January 1, 2001, and December 31, 2009. Each beneficiary's first AMI was included as their index event. Outcomes included all-cause mortality, recurrent AMI, and recurrent CHD events during the 365days after discharge for the index AMI. To examine secular trends, we pooled calendar years into 3 periods (2001-2003, 2004-2006, and 2007-2009). RESULTS: Among 48,688 beneficiaries with index AMIs from 2001 to 2009, we observed decreases in the age-adjusted rates for mortality (-3.8% for each 3-year period, 95% CI -6.1% to -1.6%, P trend = .001), recurrent AMI (-15.0%, 95% CI -18.6% to -11.2%, P trend < .001), and recurrent CHD events (-11.1%, 95% CI -14.0% to -8.0%, P trend < .001) in the 365days after the index AMI. In 2007 to 2009, blacks had excess risk relative to whites for mortality and recurrent AMI (black/white incidence rate ratio of 1.38 for mortality [95% CI 1.21-1.57] and 1.38 for recurrent AMI [95% CI 1.07-1.79]). CONCLUSIONS: Despite overall favorable trends in lower mortality and recurrent events after AMI, efforts are needed to reduce racial disparities.
Authors: Martin Wagner; Götz Gelbrich; Julia Kircher; Kornelia Kotseva; David Wood; Caroline Morbach; Rainer Leyh; Georg Ertl; Wolfgang Karmann; Stefan Störk; Peter U Heuschmann Journal: Int J Behav Med Date: 2018-06
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: Fenglong Xie; Lisandro D Colantonio; Jeffrey R Curtis; Meredith L Kilgore; Emily B Levitan; Keri L Monda; Monika M Safford; Ben Taylor; Mark Woodward; Paul Muntner Journal: Pharmacoepidemiol Drug Saf Date: 2018-03-14 Impact factor: 2.890
Authors: J Walker Blackston; Monika M Safford; Matthew T Mefford; Elizabeth Freeze; George Howard; Virginia J Howard; David C Naftel; Todd M Brown; Emily B Levitan Journal: Circ Cardiovasc Qual Outcomes Date: 2020-12-11
Authors: Oras A Alabas; Chris P Gale; Marlous Hall; Mark J Rutherford; Karolina Szummer; Sofia Sederholm Lawesson; Joakim Alfredsson; Bertil Lindahl; Tomas Jernberg Journal: J Am Heart Assoc Date: 2017-12-14 Impact factor: 6.106