Trends in myocardial infarction rates and case fatality by anatomical location in four United States communities, 1987 to 2008 (from the Atherosclerosis Risk in Communities Study).

TitleTrends in myocardial infarction rates and case fatality by anatomical location in four United States communities, 1987 to 2008 (from the Atherosclerosis Risk in Communities Study).
Publication TypeJournal Article
Year of Publication2013
AuthorsNewman JD, Shimbo D, Baggett C, Liu X, Crow R, Abraham JM, Loehr LR, Wruck LM, Folsom AR, Rosamond WD
Corporate AuthorsARIC Study Investigators
JournalAm J Cardiol
Volume112
Issue11
Pagination1714-9
Date Published2013 Dec 01
ISSN1879-1913
KeywordsAdult, Aged, Anterior Wall Myocardial Infarction, Comorbidity, Coronary Artery Bypass, Diabetes Mellitus, Female, Humans, Hypertension, Incidence, Inferior Wall Myocardial Infarction, Male, Middle Aged, Myocardial Infarction, Percutaneous Coronary Intervention, Prognosis, Retrospective Studies, Thrombolytic Therapy, United States
Abstract

Although the incidence of and mortality after ST-segment elevation myocardial infarction (STEMI) is decreasing, time trends in anatomical location of STEMI and associated short-term prognosis have not been examined in a population-based community study. We determined 22-year trends in age- and race-adjusted gender-specific incidences and 28-day case fatality of hospitalized STEMI by anatomic infarct location among a stratified random sample of 35- to 74-year-old residents of 4 communities in the Atherosclerosis Risk in Communities study. STEMI infarct location was assessed by 12-lead electrocardiograms from the hospital record and was coded as anterior, inferior, lateral, and multilocation STEMIs using the Minnesota code. From 1987 to 2008, a total of 4,845 patients had an incident STEMI; 37.2% were inferior STEMI, 32.8% were anterior, 16.8% occurred in multiple infarct locations, and 13.2% were lateral STEMI. For inferior, anterior, and lateral STEMIs in both men and women, significant decreases were observed in the age-adjusted annual incidence and the associated 28-day case fatality. In contrast, for STEMI in multiple infarct locations, neither the annual incidence nor the 28-day case fatality changed over time. The age- and race-adjusted annual incidence and associated 28-day case fatality of STEMI in anterior, inferior, and lateral infarct locations decreased during 22 years of surveillance; however, no decrease was observed for STEMI in multiple infarct locations. In conclusion, our findings suggest that there is room for improvement in the care of patients with multilocation STEMI.

DOI10.1016/j.amjcard.2013.07.037
Alternate JournalAm. J. Cardiol.
PubMed ID24063834
PubMed Central IDPMC4248564
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01 HC 55018 / HC / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01 HC 55021 / HC / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC 55022 / HC / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01 HC 55019 / HC / NHLBI NIH HHS / United States
N01 HC 55016 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01 HC 55015 / HC / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01 HC055020 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01 HC 55020 / HC / NHLBI NIH HHS / United States
N01 HC055016 / HC / NHLBI NIH HHS / United States