Contributions of event rates, pre-hospital deaths, and deaths following hospitalisation to variations in myocardial infarction mortality in 326 districts in England: a spatial analysis of linked hospitalisation and mortality data

Asaria, Perviz; Bennett, James E.; Elliott, Paul; Rashid, Theo; Daby, Hima Iyathooray; Douglass, Margaret; Francis, Dárrel P.; Fecht, Daniela; Ezzati, Majid

doi:10.1016/s2468-2667(22)00108-6

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…Myocardial infarction (MI) is one of the leading causes of death worldwide ( Li S. et al, 2022 ; Asaria et al, 2022 ). Clinically, timely reperfusion is essential to rescue ischemic myocardial tissue by reducing infarct size, maintaining left ventricular systolic function, and preventing the occurrence of heart failure.…”

Section: Introductionmentioning

confidence: 99%

Dapagliflozin alleviates myocardial ischemia/reperfusion injury by reducing ferroptosis via MAPK signaling inhibition

et al. 2023

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Reperfusion is essential for ischemic myocardium but paradoxically leads to myocardial damage that worsens cardiac functions. Ferroptosis often occurs in cardiomyocytes during ischemia/reperfusion (I/R). The SGLT2 inhibitor dapagliflozin (DAPA) exerts cardioprotective effects independent of hypoglycemia. Here, we investigated the effect and potential mechanism of DAPA against myocardial ischemia/reperfusion injury (MIRI)-related ferroptosis using the MIRI rat model and hypoxia/reoxygenation (H/R)-induced H9C2 cardiomyocytes. Our results show that DAPA significantly ameliorated myocardial injury, reperfusion arrhythmia, and cardiac function, as evidenced by alleviated ST-segment elevation, ameliorated cardiac injury biomarkers including cTnT and BNP and pathological features, prevented H/R-triggered cell viability loss in vitro. In vitro and in vivo experiments showed that DAPA inhibited ferroptosis by upregulating the SLC7A11/GPX4 axis and FTH and inhibiting ACSL4. DAPA notably mitigated oxidative stress, lipid peroxidation, ferrous iron overload, and reduced ferroptosis. Subsequently, network pharmacology and bioinformatics analysis suggested that the MAPK signaling pathway was a potential target of DAPA and a common mechanism of MIRI and ferroptosis. DAPA treatment significantly reduced MAPK phosphorylation in vitro and in vivo, suggesting that DAPA might protect against MIRI by reducing ferroptosis through the MAPK signaling pathway.

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Section: Introductionmentioning

confidence: 99%

Dapagliflozin alleviates myocardial ischemia/reperfusion injury by reducing ferroptosis via MAPK signaling inhibition

et al. 2023

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“…The Beijing Hospital Discharge Information System covers admissions to all secondary- and tertiary-level hospitals in Beijing that are authorized to admit patients and provide comprehensive in-hospital medical, prevention, rehabilitation, and health care services. AMI admissions were identified on the basis of principal discharge diagnoses with International Classification of Diseases, Tenth Revision (ICD-10) codes I21–I22 (acute myocardial infarction and subsequent myocardial infarction) [ 14 ]. The Beijing Vital Registration Monitoring System covers all deaths in Beijing [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…The Beijing Vital Registration Monitoring System covers all deaths in Beijing [ 15 ]. Deaths from AMI including both pre-hospital and in-hospital deaths were identified on the basis of the underlying cause of death using ICD-10 codes I21–I22 [ 14 ]. The diagnosis of AMI in the BCDSS has been validated as described in Supplementary Method S1 .…”

Section: Methodsmentioning

confidence: 99%

Driving Time to the Nearest Percutaneous Coronary Intervention-Capable Hospital and the Risk of Case Fatality in Patients with Acute Myocardial Infarction in Beijing

Chang

Deng

et al. 2023

IJERPH

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Timely arrival at a hospital capable of percutaneous coronary intervention (PCI) is critical in treating acute myocardial infarction (AMI). We examined the association between driving time to the nearest PCI-capable hospital and case fatality among AMI patients. A total of 142,474 AMI events during 2013–2019 from the Beijing Cardiovascular Disease Surveillance System were included in this cross-sectional study. The driving time from the residential address to the nearest PCI-capable hospital was calculated. Logistic regression was used to estimate the risk of AMI death associated with driving time. In 2019, 54.5% of patients lived within a 15-min drive to a PCI-capable hospital, with a higher proportion in urban than peri-urban areas (71.2% vs. 31.8%, p < 0.001). Compared with patients who had driving times ≤15 min, the adjusted odds ratios (95% CI, p value) for AMI fatality risk associated with driving times 16–30, 31–45, and >45 min were 1.068 (95% CI 1.033–1.104, p < 0.001), 1.189 (95% CI 1.127–1.255, p < 0.001), and 1.436 (95% CI 1.334–1.544, p < 0.001), respectively. Despite the high accessibility to PCI-capable hospitals for AMI patients in Beijing, inequality between urban and peri-urban areas exists. A longer driving time is associated with an elevated AMI fatality risk. These findings may help guide the allocation of health resources.

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“… 15 Deaths from AMI were identified according to the underlying cause of death using International Classification of Diseases, Tenth Revision ( ICD‐10 ) codes I21 to I22 (acute myocardial infarction and subsequent myocardial infarction). 4 Additionally, 2738 AMI deaths that were identified in the Hospital Discharge Information System but not in the Vital Registration Monitoring System were also included in our study. Finally, a total of 94 106 AMI deaths between 2007 and 2018 among permanent Beijing residents aged ≥35 years were included in this analysis.…”

Section: Methodsmentioning

confidence: 99%

“… 2 Information on how mortality varies geographically at the small‐area level could inform targeted and equitable health policies toward the goal of improving population health for all. 3 Prior studies in developed countries have found small‐area variation in AMI mortality within cities and have highlighted priorities for intervention efforts 4 , 5 , 6 , 7 ; however, limited data are available for developing countries.…”

mentioning

confidence: 99%

Geographic Variation in Mortality of Acute Myocardial Infarction and Association With Health Care Accessibility in Beijing, 2007 to 2018

Chang

Deng

et al. 2023

JAHA

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Background Little is known about geographic variation in acute myocardial infarction (AMI) mortality within fast‐developing megacities and whether changes in health care accessibility correspond to changes in AMI mortality at the small‐area level. Methods and Results We included data of 94 106 AMI deaths during 2007 to 2018 from the Beijing Cardiovascular Disease Surveillance System in this ecological study. We estimated AMI mortality for 307 townships during consecutive 3‐year periods with a Bayesian spatial model. Township‐level health care accessibility was measured using an enhanced 2‐step floating catchment area method. Linear regression models were used to examine the association between health care accessibility and AMI mortality. During 2007 to 2018, median AMI mortality in townships declined from 86.3 (95% CI, 34.2–173.8) to 49.4 (95% CI, 30.5–73.7) per 100 000 population. The decrease in AMI mortality was larger in townships where health care accessibility increased more rapidly. Geographic inequality, defined as the ratio of the 90th to 10th percentile of mortality in townships, increased from 3.4 to 3.8. In total, 86.3% (265/307) of townships had an increase in health care accessibility. Each 10% increase in health care accessibility was associated with a −0.71% (95% CI, −1.08% to −0.33%) change in AMI mortality. Conclusions Geographic disparities in AMI mortality among Beijing townships are large and increasing. A relative increase in township‐level health care accessibility is associated with a relative decrease in AMI mortality. Targeted improvement of health care accessibility in areas with high AMI mortality may help reduce AMI burden and improve its geographic inequality in megacities.

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Contributions of event rates, pre-hospital deaths, and deaths following hospitalisation to variations in myocardial infarction mortality in 326 districts in England: a spatial analysis of linked hospitalisation and mortality data

Cited by 8 publications

References 38 publications

Dapagliflozin alleviates myocardial ischemia/reperfusion injury by reducing ferroptosis via MAPK signaling inhibition

Dapagliflozin alleviates myocardial ischemia/reperfusion injury by reducing ferroptosis via MAPK signaling inhibition

Driving Time to the Nearest Percutaneous Coronary Intervention-Capable Hospital and the Risk of Case Fatality in Patients with Acute Myocardial Infarction in Beijing

Geographic Variation in Mortality of Acute Myocardial Infarction and Association With Health Care Accessibility in Beijing, 2007 to 2018

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