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

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 d...

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Bibliographic Details
Published in:International journal of cardiology 2013-09, Vol.168 (2), p.993-998
Main Authors: Koopman, Carla, Bots, Michiel L, van Oeffelen, Aloysia A.M, van Dis, Ineke, Verschuren, W.M. Monique, Engelfriet, Peter M, Capewell, Simon, Vaartjes, Ilonca
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Coronary heart disease
Female
Heart
Humans
Incidence
Inequalities
Male
Medical sciences
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Infarction - epidemiology
Myocardial Infarction - therapy
Myocarditis. Cardiomyopathies
Netherlands - epidemiology
Patient Discharge - trends
Population Surveillance - methods
Sex Factors
Socioeconomic Factors
Socioeconomic status
Time Factors
Treatment Outcome
Trends
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Summary: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.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2012.10.036