Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)

Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study

Gabriel Vázquez-Oliva a,b, Alberto Zamora a,c,d, Rafel Ramos a,e,f, Ruth Marti e, Isaac Subirana g,h, María Grau d,g, Irene R. Dégano d,g,i, Jaume Marrugat d,g,, Roberto Elosua d,g,i,

a Facultat de Medicina, Universitat de Girona, Girona, Spain
b Departament de Cardiologia, Hospital Sant Joan de Déu, Fundació Althaia, Manresa, Barcelona, Spain
c Unitat de Risc Vascular, Hospital de Blanes, Corporació de Salut del Maresme i la Selva, Blanes, Girona, Spain
d CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
e Grup de Recerca ISV, Unitat de Recerca en Atenció Primària, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
f Atenció Primària, Serveis Atenció Primària, Institut Català de la Salut (ICS), Girona, Spain
g Grup de Epidemiologia i Genètica Cardiovascular, Grup del estudi REGICOR (REgistre GIroní del COR). IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain
h CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
i Facultat de Medicina, Universitat de Vic-Central de Cataluña, Vic, Barcelona, Spain

Keywords

Myocardial infarction. Incidence. Mortality. Case-fatality. Older adults.

Abstract

Introduction and objectives

Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008.

Methods

A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years.

Results

The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years.

Conclusions

Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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