Trends in Incidence, Severity, and Outcome of Hospitalized Myocardial Infarction

Roger, Véronique L.; Weston, Susan A.; Gerber, Yariv; Killian, Jill M.; Dunlay, Shannon M.; Jaffe, Allan S.; Bell, Malcolm R.; Kors, Jan A.; Yawn, Barbara P.; Jacobsen, Steven J.

doi:10.1161/circulationaha.109.897249

Cited by 300 publications

(301 citation statements)

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“…Despite the declining incidence of CHD in the USA reported in the former section of this article, many (26,(39)(40)(41), but not all (42,43), observational studies have found no reduction in the incidence of MI in a variety of time periods including 1971-1982 and 1982-1992 (26), 1975-1997 (39), 1994-1999 (40), and 1987-2006 (43). In a study of 5,832 Massachusetts patients with acute MI seen between 1975 and 1997, the incidence of MI was similar in 1975-1978 and 1997, respectively (230 per 100,000 people in both periods) (39).…”

Section: What About Mi?mentioning

confidence: 67%

Epidemiology of coronary heart disease and acute coronary syndrome

Sanchís-Gomar¹,

Pérez-Quilis²,

Leischik³

et al. 2016

Ann. Transl. Med.

976

617

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The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.

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Section: What About Mi?mentioning

confidence: 67%

Epidemiology of coronary heart disease and acute coronary syndrome

Sanchís-Gomar¹,

Pérez-Quilis²,

Leischik³

et al. 2016

Ann. Transl. Med.

976

617

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“…50 These profound changes are exemplified by a decline in the incidence of myocardial infarction, 51,52 a preponderance of non-ST-segment-elevation myocardial infarctions, and a shift in the mix of heart failure cases with more patients presenting with preserved ejection fraction. 53 The impact of this evolution is amplified by 2 key factors: incident manifestations of CVD occurring at older ages and the aging of the population, which leads to a larger pool of candidates for CVD.…”

Section: How Caregiving Costs Add To the Burden Of Heart Disease Andmentioning

confidence: 99%

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

Dunbar¹,

Khavjou²,

Bakas³

et al. 2018

Circulation

198

102

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INTRODUCTION:In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. METHODS:We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. RESULTS:The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD. CONCLUSIONS:The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers.

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“…Therefore, our findings should be confirmed in different racial and ethnic groups and in other data sets. Reflecting the changing epidemiology of MI, in which non-ST-segment elevation now constitutes most MI, 46,47 only 20% of our cohort presented with ST-segment elevation. Additional assessment of differential associations between cTnT and post-MI outcomes by MI type is therefore warranted.…”

Section: Figurementioning

confidence: 99%

Prognostic Value of Cardiac Troponin T After Myocardial Infarction: A Contemporary Community Experience

Gerber

Jaffe

Weston

et al. 2012

Mayo Clinic Proceedings

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Objective: To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). Patients and Methods: Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and December 31, 2007, were studied (Nϭ1177; mean age, 68 years). Maximal cTnT value was measured at a median of 1 day after MI (median, 0.52 ng/mL; interquartile range, 0.16-1.75 ng/mL) and evaluated as a prognostic factor using measures of absolute risk. Results: During a mean follow-up of 16 months, 276 deaths (23%) occurred, 341 patients (29%) experienced a recurrent ischemic event, and 326 patients (28%) experienced heart failure. A dose-response relationship was demonstrated early after MI between cTnT and the adjusted cumulative incidence of all outcomes. The multivariateadjusted absolute risk differences (events per 100 patients) between the upper and lower cTnT tertiles at 30 days were 5.8 (95% confidence interval [CI], 1.4-10.2) for death, 5.2 (95% CI, 0.2-10.3) for recurrent ischemic event, and 6.9 (95% CI, 1.4-12.4) for heart failure. These differences were either maintained or increased at 2 years. Conclusion: In the community, cTnT level predicts death and nonfatal cardiac events independently of other prognostic factors. The increased risk associated with elevated cTnT level appears shortly after MI and persists for at least 2 years.

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Trends in Incidence, Severity, and Outcome of Hospitalized Myocardial Infarction

Abstract: Background-In 2000, the definition of myocardial infarction (MI) changed to rely on troponin rather than creatine kinase (CK) and its MB fraction (CK-MB). The implications of this change on trends in MI incidence and outcome are not defined. Methods and Results-This

Cited by 300 publications

References 32 publications

Epidemiology of coronary heart disease and acute coronary syndrome

Epidemiology of coronary heart disease and acute coronary syndrome

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

Prognostic Value of Cardiac Troponin T After Myocardial Infarction: A Contemporary Community Experience

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