Trends in myocardial infarction and coronary revascularisation procedures in Australia, 1993–2017

Abstract

ObjectivePrior data have shown rising acute myocardial infarction (MI) trends in Australia; whether these increases have continued in recent years is not known. This study thus sought to characterise contemporary nationwide trends in MI hospitalisations and coronary procedures in Australia and their associated economic burden.MethodsThe primary outcome measure was the incidence and time trends of total MI, ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) hospitalisations from 1993 to 2017. The incidence and time trends of coronary procedures were additionally collected, alongside MI hospitalisation costs.ResultsAdjusted for population changes, annual MI incidence increased from 216.2 cases per 100 000 to a peak of 270.4 in 2007 with subsequent decline to 218.7 in 2017. Similarly, NSTEMI incidence increased from 68.0 cases per 100 000 in 1993 to a peak of 192.6 in 2007 with subsequent decline to 162.6 in 2017. STEMI incidence decreased from 148.3 cases per 100 000 in 1993 to 56.2 in 2017. Across the study period, there were annual increases in MI hospitalisations of 0.7% and NSTEMI hospitalisations of 5.6%, and an annual decrease in STEMI hospitalisations of 4.8%. Angiography and percutaneous coronary intervention increased by 3.4% and 3.3% annually, respectively, while coronary artery bypass graft surgery declined by 2.2% annually. MI hospitalisation costs increased by 100% over the study period, despite a decreased average length of stay by 45%.ConclusionsThe rising incidence of MI hospitalisations appear to have stabilised in Australia. Despite this, associated healthcare expenditure remains significant, suggesting a need for continual implementation of public health policies and preventative strategies.

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

“…In Australia, survival post‐PCI has remained relatively stable from 2002 except for the 2014‐to‐2016 period where there was a decrease in survival, potentially due to risk factors for CHD prevention, such as physical inactivity 32 . Trends in PCI have seen a decrease in length of stay and an increase of PCIs in the older population 33 . This is particularly relevant considering the association we found with age and activity level post‐PCI.…”

“… 32 Trends in PCI have seen a decrease in length of stay and an increase of PCIs in the older population. 33 This is particularly relevant considering the association we found with age and activity level post‐PCI. Older age 34 and comorbidities 34 , 35 , 36 have been associated with unplanned hospital admissions within the first 30 days post‐PCI, with readmission rates up to 17%.…”