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

被引：76

作者：

Reynolds, Kristi ^{[1
]}

Go, Alan S. ^{[2
,3
,4
,5
,6
]}

Leong, Thomas K. ^{[2
]}

Boudreau, Denise M. ^{[7
]}

Cassidy-Bushrow, Andrea E. ^{[8
]}

Fortmann, Stephen P. ^{[9
]}

Goldberg, Robert J. ^{[10
]}

Gurwitz, Jerry H. ^{[11
,12
]}

Magid, David J. ^{[13
,14
,15
]}

Margolis, Karen L. ^{[16
]}

McNeal, Catherine J. ^{[17
]}

Newton, Katherine M. ^{[7
]}

Novotny, Rachel ^{[18
]}

Quesenberry, Charles P., Jr. ^{[2
]}

Rosamond, Wayne D. ^{[19
]}

Smith, David H. ^{[9
]}

VanWormer, Jeffrey J. ^{[20
]}

Vupputuri, Suma ^{[21
]}

Waring, Stephen C. ^{[22
]}

Williams, Marc S. ^{[23
]}

Sidney, Stephen ^{[2
]}

机构：

[1] Kaiser Permanente Southern Calif, Dept Res & Evaluat, 100 S Los Robles,2nd Floor, Pasadena, CA 91101 USA

[2] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[3] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA

[4] Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA

[5] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[6] Stanford Univ, Sch Med, Dept Hlth Res & Policy, Stanford, CA 94305 USA

[7] Grp Hlth Res Inst, Seattle, WA USA

[8] Henry Ford Hlth Syst, Dept Publ Hlth Sci, Detroit, MI USA

[9] Kaiser Permanente Ctr Hlth Res, Portland, OR USA

[10] Univ Massachusetts, Sch Med, Dept Quantitat Hlth Sci, Worcester, PA USA

[11] Meyers Primary Care Inst, Reliant Med Grp, Worcester, PA USA

[12] Univ Massachusetts, Sch Med, Worcester, PA USA

[13] Colorado Permanente Med Grp, Denver, CO USA

[14] Univ Colorado Denver, Colorado Sch Publ Hlth, Aurora, CO USA

[15] Colorado Cardiovasc Outcomes Res Consortium, Denver, CO USA

[16] HealthPartners Inst Educ & Res, Minneapolis, MN USA

[17] Baylor Scott & White Hlth, Dept Internal Med, Div Cardiol, Temple, TX USA

[18] Univ Hawaii Manoa, Coll Trop Agr & Human Resources, Human Nutr Food & Anim Sci Dept, Honolulu, HI 96822 USA

[19] Univ North Carolina Chapel Hill, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC USA

[20] Marshfield Clin Res Fdn, Ctr Clin Epidemiol & Populat Hlth, Marshfield, WI USA

[21] Kaiser Permanente Midatlantic States, Midatlantic Permanente Res Inst, Rockville, MD USA

[22] Essentia Inst Rural Hlth, Div Res, Duluth, MN USA

[23] Geisinger Hlth Syst, Genom Med Inst, Danville, PA USA

来源：

AMERICAN JOURNAL OF MEDICINE | 2017年 / 130卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Acute myocardial infarction; Cardiovascular disease; Epidemiology; Sex differences; Trends; CORONARY-HEART-DISEASE; UNITED-STATES; US ADULTS; WOMENS AWARENESS; NATIONAL-HEALTH; CASE-FATALITY; MEDICAL-CARE; RISK-FACTORS; PREVALENCE; MORTALITY;

D O I：

10.1016/j.amjmed.2016.09.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 nonST-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. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：317 / 327

页数：11

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