Age-Specific Trends in the Incidence and In-Hospital Mortality of Acute Myocardial Infarction Over 30 Years in Japan　— Report From the Miyagi AMI Registry Study —

Abstract

years since 1979, where almost all AMI patients in the Miyagi Prefecture have been prospectively registered. [18][19][20] In a previous report, we demonstrated the trend for increasing incidence and decreasing in-hospital mortality of AMI from 1979 Since then, we have been facing rapid social aging in Japan, where such aging should affect the actual situation of cardiovascular diseases, including AMI. Thus, in the present study, we examined the temporal age-specific trends in the incidence and inhospital mortality of AMI during the past 30 years (from 1985 to 2014) in our Miyagi AMI Registry. MethodsThe present study was approved by the Institutional Review Board of Tohoku University Graduate School of Medicine A cute myocardial infarction (AMI) is a leading cause of death and a serious public health problem worldwide, especially in developed countries. 1-3 In Western countries, decreasing trends in the incidence and mortality of AMI have been reported since the 1980 s, 4-8 in association with public efforts to reduce coronary risk factors and improved critical care for AMI (e.g., reperfusion therapies). 9-11 In contrast, in Asian countries, including Japan, Taiwan and Korea, AMI has become more common because of prolonged life expectancy, rapid socioeconomic advances, and westernization of life style and diet. 12, 13 In Japan, there have been a few registry studies of AMI and most of them included a relatively small number of patients and/or a relatively short study period. 14-17 In order to elucidate the accurate trend of AMI in Japan, we have been conducting the Miyagi AMI Registry Study for 37 Background: We are now facing rapid population aging in Japan, which will affect the actual situation of cardiovascular diseases. However, age-specific trends in the incidence and mortality of acute myocardial infarction (AMI) in Japan remain to be elucidated.

Temporal Trends in Acute Myocardial Infarction Incidence and Mortality Between 2006 and 2016 in Tokyo ― Report From the Tokyo CCU Network ―

“…There have been a few registry studies of AMI but most of them included relatively small numbers of patients. [2][3][4] As of October 1, 2015, the population of the Tokyo metropolitan area was estimated to be 13.5 million and expressed as approximately 10% of Japan's total population. Here, the Tokyo CCU Network operates to treat patients with emergency cardiovascular diseases as promptly as possible, with the help of ambulance units through the control room of the Tokyo Fire Department.…”

“…These results may be related to the increased prevalence of metabolic risk factors in young populations and the increased use of antihypertensive agents and statins for primary prevention in the elderly. 3,11 A universal definition of AMI using cardiac troponin was widely used during the study period. Thus there is potential for an increase in the diagnostic numbers rather ≥80 years (P=0.006) and 60-69 years (P=0.036).…”

Geographic Variations in In‐Hospital Mortality and Use of Percutaneous Coronary Intervention Following Acute Myocardial Infarction in China: A Nationwide Cross‐Sectional Analysis

“…In-hospital and 30-day mortality rates for AMI patients in these studies ranged from 4.54% to 10.1% and from 6% to 16.1%, respectively. 6,8,15,[48][49][50][51] Even within China, region-, province-, and hospital-level IHM rates vary in studies using sampled data. 24,52 These differences in AMI patients' outcomes suggest an urgent need for timely, nationwide statistics for AMI in China to assist policy makers.…”

A Novel Predictive Model for In-Hospital Mortality Based on a Combination of Multiple Blood Variables in Patients with ST-Segment-Elevation Myocardial Infarction

“…Over the last 2 decades, advances in the coronary care unit and primary reperfusion therapy have improved the outcome of the chronic phase after an AMI [2]. Although the incidence of in-hospital death in patients with AMI also declined up to the first decade of the twenty-first century [3,4], thereafter improvement in mortality appeared to plateau [5]. Intriguingly, the incidence of in-hospital death in Japan has been significantly higher in patients with ST-segment elevation myocardial infarction (STEMI) than in patients with non-STEMI (7.7% vs. 5.1%), despite the recently introduced settings of optimal infarction (STEMI) than in patients with non-STEMI (7.7% vs. 5.1%), despite the recently introduced settings of optimal medical therapy and successful reperfusion after primary percutaneous coronary intervention (PCI) [6].…”