Sanne A E Peters1,2,3, Lisandro D Colantonio4, Yuling Dai4, Hong Zhao4, Vera Bittner5, Michael E Farkouh6, Paul Dluzniewski7, Bharat Poudel4, Paul Muntner4, Mark Woodward1,3,8. 1. The George Institute for Global Health, Imperial College London, UK (S.A.E.P., M.W.). 2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands (S.A.E.P.). 3. The George Institute for Global Health, University of New South Wales, Sydney, Australia (S.A.E.P., M.W.). 4. Department of Epidemiology (L.D.C., Y.D., H.Z., B.P., P.M.), University of Alabama at Birmingham. 5. Division of Cardiovascular Disease (V.B.), University of Alabama at Birmingham. 6. Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, ON, Canada (M.E.F.). 7. Center for Observational Research, Amgen Inc, Thousand Oaks, CA (P.D.). 8. Department of Epidemiology, Johns Hopkins University, Baltimore, MD (M.W.).
Abstract
BACKGROUND: Rates for recurrent coronary heart disease (CHD) events have declined in the United States. However, few studies have assessed whether this decline has been similar among women and men. METHODS: Data were used from 770 408 US women and 700 477 US men <65 years of age with commercial health insurance through MarketScan and ≥66 years of age with government health insurance through Medicare who had a myocardial infarction (MI) hospitalization between 2008 and 2017. Women and men were followed up for recurrent MI, recurrent CHD events (ie, recurrent MI or coronary revascularization), heart failure hospitalization, and all-cause mortality (Medicare only) in the 365 days after MI. RESULTS: From 2008 to 2017, age-standardized recurrent MI rates per 1000 person-years decreased from 89.2 to 72.3 in women and from 94.2 to 81.3 in men (multivariable-adjusted P interaction by sex <0.001). Recurrent CHD event rates decreased from 166.3 to 133.3 in women and from 198.1 to 176.8 in men (P interaction <0.001). Heart failure hospitalization rates decreased from 177.4 to 158.1 in women and from 162.9 to 156.1 in men (P interaction=0.001). All-cause mortality rates decreased from 403.2 to 389.5 in women and from 436.1 to 417.9 in men (P interaction=0.82). In 2017, the multivariable-adjusted rate ratios comparing women with men were 0.90 (95% CI, 0.86-0.93) for recurrent MI, 0.80 (95% CI, 0.78-0.82) for recurrent CHD events, 0.99 (95% CI, 0.96-1.01) for heart failure hospitalization, and 0.82 (95% CI, 0.80-0.83) for all-cause mortality. CONCLUSIONS: Rates of recurrent MI, recurrent CHD events, heart failure hospitalization, and mortality in the first year after an MI declined considerably between 2008 and 2017 in both men and women, with proportionally greater reductions for women than men. However, rates remain very high, and rates of recurrent MI, recurrent CHD events, and death continue to be higher among men than women.
BACKGROUND: Rates for recurrent coronary heart disease (CHD) events have declined in the United States. However, few studies have assessed whether this decline has been similar among women and men. METHODS: Data were used from 770 408 US women and 700 477 US men <65 years of age with commercial health insurance through MarketScan and ≥66 years of age with government health insurance through Medicare who had a myocardial infarction (MI) hospitalization between 2008 and 2017. Women and men were followed up for recurrent MI, recurrent CHD events (ie, recurrent MI or coronary revascularization), heart failure hospitalization, and all-cause mortality (Medicare only) in the 365 days after MI. RESULTS: From 2008 to 2017, age-standardized recurrent MI rates per 1000 person-years decreased from 89.2 to 72.3 in women and from 94.2 to 81.3 in men (multivariable-adjusted P interaction by sex <0.001). Recurrent CHD event rates decreased from 166.3 to 133.3 in women and from 198.1 to 176.8 in men (P interaction <0.001). Heart failure hospitalization rates decreased from 177.4 to 158.1 in women and from 162.9 to 156.1 in men (P interaction=0.001). All-cause mortality rates decreased from 403.2 to 389.5 in women and from 436.1 to 417.9 in men (P interaction=0.82). In 2017, the multivariable-adjusted rate ratios comparing women with men were 0.90 (95% CI, 0.86-0.93) for recurrent MI, 0.80 (95% CI, 0.78-0.82) for recurrent CHD events, 0.99 (95% CI, 0.96-1.01) for heart failure hospitalization, and 0.82 (95% CI, 0.80-0.83) for all-cause mortality. CONCLUSIONS: Rates of recurrent MI, recurrent CHD events, heart failure hospitalization, and mortality in the first year after an MI declined considerably between 2008 and 2017 in both men and women, with proportionally greater reductions for women than men. However, rates remain very high, and rates of recurrent MI, recurrent CHD events, and death continue to be higher among men than women.
Entities:
Keywords:
myocardial infarction; secondary prevention; sex characteristics; trends
Authors: Brian A Bergmark; Njambi Mathenge; Piera A Merlini; Marilyn B Lawrence-Wright; Robert P Giugliano Journal: Lancet Date: 2022-04-02 Impact factor: 79.321
Authors: Jolanta Zalejska-Fiolka; Anna Birková; Tomasz Wielkoszyński; Beáta Hubková; Beata Szlachta; Rafał Fiolka; Urszula Błaszczyk; Aleksandra Kuzan; Andrzej Gamian; Mária Mareková; Michał Toborek Journal: Int J Environ Res Public Health Date: 2022-01-17 Impact factor: 3.390