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)

Jonathan D. Newman, Daichi Shimbo, Chris Baggett, Xiaoxi Liu, Richard Crow, Joellyn M. Abraham, Laura R. Loehr, Lisa M. Wruck, Aaron R. Folsom, Wayne D. Rosamond

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1714-1719
Number of pages6
JournalAmerican Journal of Cardiology
Volume112
Issue number11
DOIs
StatePublished - Dec 1 2013

Bibliographical note

Funding Information:
The ARIC Study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts N01-HC-55015 , N01- HC-55016 , N01-HC-55018 , N01-HC-55019 , N01-HC-55020 , N01-HC-55021 , and N01-HC-55022 .

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