Favourable trends in the incidence and outcome of myocardial infarction in nondiabetic, but not in diabetic, subjects: findings from the MONICA myocardial infarction registry in northern Sweden in 1989–2000

Rautio, Aslak; Lundberg, Vivan; Messner, Torbjörn; Nasic, Salmir; Stegmayr, Birgitta; Eliasson, Mats

doi:10.1111/j.1365-2796.2005.01552.x

Cited by 25 publications

(22 citation statements)

References 44 publications

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“…Compared with Germany, the RRs for MI in diabetic compared with non-diabetic individuals were much higher in Sweden (RR approx. 8 and 15 for men and women, respectively) [13]. The authors of this study also failed to find an explanation for their findings.…”

Section: Discussioncontrasting

confidence: 68%

“…In the USA, a sharp increase in the number of diabetic patients hospitalised for MI was observed between 1988 and 2002, but the study was based on hospital discharge data and MI incidence in the diabetic and non-diabetic populations was not analysed [11]. Only one study has analysed the trend of MI incidence [13]. In contrast to our study, it found that the incidence of first MI decreased only in non-diabetic men, with a decline in the incidence of first MI seen neither in non-diabetic women, nor in diabetic men or women.…”

Section: Discussionmentioning

confidence: 99%

“…Analyses from Norway and the US have been based on cross-sectional surveys or hospital discharge data [11,12]. Only one study to date has evaluated the trend of MI incidence in diabetic and nondiabetic individuals, finding favourable trends in the latter, but not in diabetic individuals [13].…”

Section: Introductionmentioning

confidence: 99%

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Differences in trends in estimated incidence of myocardial infarction in non-diabetic and diabetic people: Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) registry

et al. 2009

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Aims/hypothesis One major objective of the St Vincent Declaration was to reduce the excess risk of myocardial infarction in patients with diabetes mellitus. We estimated the trend of the incidence and relative risk of myocardial infarction in the diabetic and non-diabetic populations in southern Germany from 1985 to 2006. We estimated the diabetic and the non-diabetic populations using data on diabetes prevalence from surveys, and evaluated incidence of myocardial infarction in the two estimated populations. To test for time trends, we fitted Poisson regression models. Results Of individuals with first myocardial infarction, 71% were male and 28% known to have diabetes. In the non-diabetic population, myocardial infarction incidence decreased by about 1.5% to 2.0% per year. A comparable decrease was seen in the population of diabetic women. However, in the population of diabetic men, incidence of myocardial infarction increased by about 1% per year. Over the whole study period, myocardial infarction incidence decreased by 34% and 27% in non-diabetic men and women respectively (RR 0.66,. In diabetic women, it decreased by 27% (RR 0.73, 0.61-0.88), whereas in diabetic men, it increased by 25% (RR 1.25, 1.07-1.45). Conclusions/interpretation Our results suggest that the St Vincent goal of reducing excess cardiovascular morbidity in diabetic individuals has not been achieved and that the situation in men has actually got worse. Methods

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Differences in trends in estimated incidence of myocardial infarction in non-diabetic and diabetic people: Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) registry

et al. 2009

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“…The OR for study year is per 1 year increment. For numbers of fatal and all first ACS events, see Table 1 Table 2 while, over the same time, all these indicators developed positively in the non-diabetic population [13]. Furthermore, investigators from UK have reported a comparison of treatment given to patients with and without diabetes who sustained a myocardial infarction in 1995 or 2003.…”

Section: Discussionmentioning

confidence: 99%

“…It is, however, unclear to what extent diabetic patients have benefited from this favourable general development. Studies from the USA, Sweden and UK have suggested that the trends have been less favourable in diabetic than in nondiabetic ACS patients [12][13][14]. These studies also indicate that development has been very slow in diabetic women.…”

Section: Introductionmentioning

confidence: 98%

Case fatality rates after first acute coronary syndrome in persons treated for type 2 diabetes show an improving trend

et al. 2009

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Aims/hypothesis We analysed whether the prognosis of a first acute coronary syndrome (ACS) in patients treated for type 2 diabetes has improved. We also compared the trends in patients with and without diabetes. Methods We used national registers to identify all patients with clinically known type 2 diabetes in Finland during the years 1988 to 2002 (n=222,940). All first-ever ACS events (n=43,412) among these patients were identified using the Hospital Discharge Register and the Causes of Death Register. From the National Cardiovascular Disease Register we identified all first ACS attacks (n=191,403) among non-diabetic patients in the country. Finally, we calculated annual age-standardised case fatality rates for ACS for three time periods: prehospital, days 0 to 27 and days 28 to 364 after the first ACS. Results The case fatality rate of first ACS declined significantly in both sexes at all time points considered. The declining trends were not different between patients with type 2 diabetes and those without. Among men aged 35 to 74 years, 58.5% (95% CI 57.6-59.4%) with type 2 diabetes and 44.1% (95% CI 43.8-44.5%) without diabetes had died from cardiovascular causes 1 year after their first ACS. Among women of the same age, the corresponding figures were 54.2% (95% CI 53.0-55.4%) and 36.5% (95% CI 35.9-37.1%). Men generally had higher case fatality rates than women. However, except for prehospital deaths, diabetic women had the same or even higher case fatality rates than non-diabetic men. Conclusions/interpretation The case fatality rates for first ACS show similar improving trends in patients with type 2 diabetes and in those without. However, case fatality rates have remained higher in patients with type 2 diabetes.

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Regional variation in the incidence of abdominal aortic aneurysm in Sweden

Hultgren

Forsberg

Alfredsson

et al. 2012

British Journal of Surgery

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Favourable trends in the incidence and outcome of myocardial infarction in nondiabetic, but not in diabetic, subjects: findings from the MONICA myocardial infarction registry in northern Sweden in 1989–2000

Cited by 25 publications

References 44 publications

Differences in trends in estimated incidence of myocardial infarction in non-diabetic and diabetic people: Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) registry

Differences in trends in estimated incidence of myocardial infarction in non-diabetic and diabetic people: Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) registry

Case fatality rates after first acute coronary syndrome in persons treated for type 2 diabetes show an improving trend

Regional variation in the incidence of abdominal aortic aneurysm in Sweden

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