Incidence and outcome of first myocardial infarction according to gender and age in Denmark over a 35-year period (1978–2012)

Alzuhairi, Karam Sadoon; Søgaard, Peter; Ravkilde, Jan; Gislason, Gunnar; Køber, Lars; Torp‐Pedersen, Christian

doi:10.1093/ehjqcco/qcv016

Cited by 33 publications

(19 citation statements)

References 38 publications

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“…1,2 There is no better example of this than the immediate impact of smoke-free legislation on the incidence of AMI in those countries where it has been successfully implemented. 3,4 Declines in hospitalization rates have been matched by reductions in case fatality rates, 5 both acutely and during follow-up, reflecting the widespread application of evidencebased treatment such as reperfusion therapy and drugs to protect against the progression of coronary disease. Many of these same treatments are also protective against other manifestations of cardiovascular disease, particularly stroke.…”

Section: Introductionmentioning

confidence: 99%

European Society of Cardiology: Cardiovascular Disease Statistics 2019

Timmis

Townsend

Gale

et al. 2019

European Heart Journal

840

468

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Aims The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. Methods and results In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5–23.1%] vs. 15.7% (IQR 14.5–21.1%)}, diabetes [7.7% (IQR 7.1–10.1%) vs. 5.6% (IQR 4.8–7.0%)], and among males smoking [43.8% (IQR 37.4–48.0%) vs. 26.0% (IQR 20.9–31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0–10.8) vs. 16.7% (IQR 13.9–19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655–8115)] compared with high-income [2235 (IQR 1896–3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. Conclusion A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest.

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Section: Introductionmentioning

confidence: 99%

European Society of Cardiology: Cardiovascular Disease Statistics 2019

Timmis

Townsend

Gale

et al. 2019

European Heart Journal

840

468

View full text Add to dashboard Cite

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“…No previous studies have presented population-based data on organ failure incidence, but studies of other time-dependent conditions report a population-based incidence of sepsis from 260–780/100 000 py,34–37 an incidence of shock at 75/100 000 py,5 an incidence of stroke 90–150/100 000 py,38 39 and for myocardial infarction an incidence of 210–300/100 000 py,40 41 all lower than the incidence of organ failure presented. This demonstrates that patients with organ failure are frequent and important as well from a public health and prehospital point of view, as well as from an ED point of view.…”

Section: Discussionmentioning

confidence: 90%

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

et al. 2019

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ObjectivesThe aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.DesignThis was a population-based cohort study of all citizens in four municipalities (population of 230 000 adults).SettingEmergency department at Odense University Hospital, Denmark.ParticipantsWe included all adult patients who arrived from 1 April 2012 to 31 March 2015.Primary and secondary outcome measuresOrgan failure was defined as a modified Sequential Organ Failure Assessment score≥2 within six possible organ systems: cerebral, circulatory, renal, respiratory, hepatic and coagulation.The primary outcome was prevalence of organ failure, and secondary outcomes were 0–7 days, 8–30 days and 31–365 days all-cause mortality.ResultsWe identified in total 175 278 contacts, of which 70 399 contacts were further evaluated for organ failure. Fifty-two per cent of these were women, median age 62 (IQR 42–77) years. The incidence of new organ failure was 1342/100 000 person-years, corresponding to 5.2% of all emergency department contacts.The 0–7-day, 8–30-day and 31–365-day mortality was 11.0% (95% CI: 10.2% to 11.8%), 5.6% (95% CI: 5.1% to 6.2%) and 13.2% (95% CI: 12.3% to 14.1%), respectively, if the patient had one or more new organ failures at first contact in the observation period, compared with 1.4% (95% CI: 1.3% to 1.6%), 1.2% (95% CI: 1.1% to 1.3%) and 5.2% (95% CI: 5.0% to 5.4%) for patients without. Seven-day mortality ranged from hepatic failure, 6.5% (95% CI: 4.9% to 8.6%), to cerebral failure, 33.8% (95% CI: 31.0% to 36.8%), the 8–30-day mortality ranged from cerebral failure, 3.9% (95% CI: 2.8% to 5.3%), to hepatic failure, 8.6% (95% CI: 6.6% to 10.8%) and 31–365-day mortality ranged from cerebral failure, 9.3% (95% CI: 7.6% to 11.2%), to renal failure, 18.2% (95% CI: 15.5% to 21.1%).ConclusionsThe study revealed an incidence of new organ failure at 1342/100 000 person-years and a prevalence of 5.2% of all emergency department contacts. One-year all-cause mortality was 29.8% among organ failure patients.

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“…In coronary disease, most studies of outcomes following myocardial infarction (MI) have focused on the acute phase post-MI, typically up to 1 year. However, given marked improvements over the past decade in short-term and long-term mortality following MI, 4–6 there is a growing need to characterize the outcomes experienced by patients in whom follow-up begins after the acute phase. By the time of the first anniversary following admission for an acute MI, dual antiplatelet therapy, 7–10 cardiac rehabilitation, and cardiologist follow-up 11 have commonly ended, and uptake of secondary prevention medication may be declining.…”

Section: Introductionmentioning

confidence: 99%

Using big data from health records from four countries to evaluate chronic disease outcomes: a study in 114 364 survivors of myocardial infarction

Rapsomaniki

Thuresson

Yang³

et al. 2016

Eur Heart J Qual Care Clin Outcomes

101

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AimsTo assess the international validity of using hospital record data to compare long-term outcomes in heart attack survivors.Methods and resultsWe used samples of national, ongoing, unselected record sources to assess three outcomes: cause death; a composite of myocardial infarction (MI), stroke, and all-cause death; and hospitalized bleeding. Patients aged 65 years and older entered the study 1 year following the most recent discharge for acute MI in 2002–11 [n = 54 841 (Sweden), 53 909 (USA), 4653 (England), and 961 (France)]. Across each of the four countries, we found consistent associations with 12 baseline prognostic factors and each of the three outcomes. In each country, we observed high 3-year crude cumulative risks of all-cause death (from 19.6% [England] to 30.2% [USA]); the composite of MI, stroke, or death [from 26.0% (France) to 36.2% (USA)]; and hospitalized bleeding [from 3.1% (France) to 5.3% (USA)]. After adjustments for baseline risk factors, risks were similar across all countries [relative risks (RRs) compared with Sweden not statistically significant], but higher in the USA for all-cause death [RR USA vs. Sweden, 1.14 (95% confidence interval 1.04–1.26)] and hospitalized bleeding [RR USA vs. Sweden, 1.54 (1.21–1.96)].ConclusionThe validity of using hospital record data is supported by the consistency of estimates across four countries of a high adjusted risk of death, further MI, and stroke in the chronic phase after MI. The possibility that adjusted risks of mortality and bleeding are higher in the USA warrants further study.

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Incidence and outcome of first myocardial infarction according to gender and age in Denmark over a 35-year period (1978–2012)

Cited by 33 publications

References 38 publications

European Society of Cardiology: Cardiovascular Disease Statistics 2019

European Society of Cardiology: Cardiovascular Disease Statistics 2019

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

Using big data from health records from four countries to evaluate chronic disease outcomes: a study in 114 364 survivors of myocardial infarction

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