Trends in Acute Myocardial Infarction Hospitalization Rates for US States in the CDC Tracking Network

Abstract

ObjectivesWe examined temporal trends, spatial variation, and gender differences in rates of hospitalization due to acute myocardial infarction.MethodsWe used data from the Centers for Disease Control National Environmental Public Health Tracking Network to evaluate temporal trends, geographic variation, and gender differences in 20 Environmental Public Health Tracking Network states from 2000 to 2008. A longitudinal linear mixed effects model was fitted to the acute myocardial infarction hospitalization rates for the states and counties within each state to examine the overall temporal trend.ResultsThere was a significant overall decrease in age-adjusted acute myocardial infarction hospitalization rates between 2000 and 2008, with most states showing over a 20% decline during the period. The ratio of male/female rates for acute myocardial infarction hospitalization rates remained relatively consistent over time, approximately two-fold higher in men compared to women. A large geographic variability was found for age-adjusted acute myocardial infarction hospitalization rates, with the highest rates found in the Northeastern states. Results of two ecological analyses revealed that the NE region remained significantly associated with increased AMI hospitalization rates after adjustment for socio-demographic factors.ConclusionsThis investigation is one of the first to explore geographic differences in AMI age adjusted hospital rates in individuals 35+ years of age for 2000–2008. We showed a decreasing trend in AMI hospitalization rates in men and women. A large geographic variability in rates was found with particularly higher rates in the New England/Mid-Atlantic region of the US and lower rates in the mountain and Pacific states of the tracking network. It appeared that over time this disparity in rates became less notable.

Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

“…However, while aging does tend to increase the prevalence of IHD, we estimated that prevalence rates for IHD will actually decline during 2015-2024. This finding is consistent with long-standing trends toward decreasing prevalence of acute coronary syndrome across all age groups in the U.S. population (Krumholz, Normand, & Wang, 2014;Talbott et al, 2013). However, this decline largely represents an extrapolation of recent declines in the prevalence of IHD noted in MEPS; this finding assumes that the previous trend toward reduced prevalence of IHD will continue.…”

Trends in and disparities for acute myocardial infarction: an analysis of Medicare claims data from 1992 to 2010

“…This implies that only some racial and sex differences were attributable to age and period effects, and some disparities still persisted, although they narrowed in adjusted analyses. Another study using the CDC data reported that the male-female ratio for AMI hospitalization rates remained constant at 2:1 from 2000 to 2008 [21]. Second, we found a marked increase in the utilization of revascularization among all patient cohorts over time.…”

“…Chen and Krumholz examined trends in AMI hospitalization among Medicare beneficiaries between 2002 and 2007 and noted an approximately 20% decline in hospitalization rates [20]; they also found evidence of higher AMI hospitalization rates among men compared to women and white men as compared to black men. Similarly, Talbott et al reported a 20% decline in AMI hospitalization rates using the Centers for Disease Control (CDC) data [21]. Alternatively, data show declines in cardiovascular disease mortality over time without corresponding reductions in AMI hospitalization rates [22].…”

“…Revascularization included the receipt of three complementary cardiac procedures: 1) coronary angiography (with or without percutaneous coronary intervention (PCI); ICD-9-CM codes 37. 21 We assessed receipt of each procedure at three different time-points: 1) during the index hospitalization (that is, at the admitting hospital); 2) during the index admission but after transfer from the admitting hospital to a second facility; and 3) within 30 days of AMI admission (which included procedures performed at the admitting hospital, after transfer, or during a subsequent readmission). Patients who underwent multiple procedures (for example, angiography plus CABG) were included in the counts for each.…”

Engaging academia to advance the science and practice of environmental public health tracking

“…They have conducted a descriptive analysis of temporal trends, spatial variation, and gender differences in age-adjusted rates of hospitalizations for AMI using data currently available on the Tracking Network (Talbott et al, 2013). Results showed a 20% decrease in AMI hospitalizations from 2000 to 2008 for most Tracking states, higher rates in the New England/Mid-Atlantic region, and two-fold higher rates among men than women.…”