Trends in clinical, demographic, and biochemical characteristics of patients with acute myocardial infarction from 2003 to 2008: a report from the american heart association get with the guidelines coronary artery disease program.

Boyer, Nathan M

Laskey, Warren K

Cox, Margueritte

Hernandez, Adrian F

Peterson, Eric D

Bhatt, Deepak L

Cannon, Christopher P

Fonarow, Gregg C

England

2017-07-06T13:37:46Z

2017-07-06T13:37:46Z

2012-08

BACKGROUND: An analysis of the changes in the clinical and demographic characteristics of patients with acute myocardial infarction could identify successes and failures of risk factor identification and treatment of patients at increased risk for cardiovascular events. METHODS AND RESULTS: We reviewed data collected from 138 122 patients with acute myocardial infarction admitted from 2003 to 2008 to hospitals participating in the American Heart Association Get With The Guidelines Coronary Artery Disease program. Clinical, demographic, and laboratory characteristics were analyzed for each year stratified on the electrocardiogram at presentation. Patients with non-ST-segment-elevation myocardial infarction were older, more likely to be women, and more likely to have hypertension, diabetes mellitus, and a history of past cardiovascular disease than were patients with ST-elevation myocardial infarction. In the overall patient sample, significant trends were observed of an increase over time in the proportions of non-ST-segment-elevation myocardial infarction, patient age of 45 to 65 years, obesity, and female sex. The prevalence of diabetes mellitus decreased over time, whereas the prevalences of hypertension and smoking were substantial and unchanging. The prevalence of "low" high-density lipoprotein increased over time, whereas that of "high" low-density lipoprotein decreased. Stratum-specific univariate analysis revealed quantitative and qualitative differences between strata in time trends for numerous demographic, clinical, and biochemical measures. On multivariable analysis, there was concordance between strata with regard to the increase in prevalence of patients 45 to 65 years of age, obesity, and "low" high-density lipoprotein and the decrease in prevalence of "high" low-density lipoprotein. However, changes in trends in age distribution, sex ratio, and prevalence of smokers and the magnitude of change in diabetes mellitus prevalence differed between strata. CONCLUSIONS: There were notable differences in risk factors and patient characteristics among patients with ST-elevation myocardial infarction and those with non-ST-segment-elevation myocardial infarction. The increasing prevalence of dysmetabolic markers in a growing proportion of patients with acute myocardial infarction suggests further opportunities for risk factor modification. (J Am Heart Assoc. 2012;1:e001206 doi: 10.1161/JAHA.112.001206.).

https://www.ncbi.nlm.nih.gov/pubmed/23130159

jah367

2047-9980

https://hdl.handle.net/10161/14995

eng

Ovid Technologies (Wolters Kluwer Health)

J Am Heart Assoc

10.1161/JAHA.112.001206

coronary disease

epidemiology

myocardial infarction

population

risk factors

Trends in clinical, demographic, and biochemical characteristics of patients with acute myocardial infarction from 2003 to 2008: a report from the american heart association get with the guidelines coronary artery disease program.

Journal article

Hernandez, Adrian F|0000-0003-3387-9616

Peterson, Eric D|0000-0002-5415-4721

https://www.ncbi.nlm.nih.gov/pubmed/23130159

e001206

4

Clinical Science Departments

Duke

Duke Clinical Research Institute

Institutes and Centers

Medicine

Medicine, Cardiology

School of Medicine

Published

1