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

Rev Esp Cardiol (Engl Ed). 2018 Sep;71(9):718-725. doi: 10.1016/j.rec.2017.10.019. Epub 2017 Nov 22.
[Article in English, Spanish]

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.

Keywords: Adultos mayores; Case-fatality; Incidence; Incidencia; Infarto de miocardio; Letalidad; Mortalidad; Mortality; Myocardial infarction; Older adults.

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cause of Death / trends
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Population Surveillance*
  • Registries*
  • Retrospective Studies
  • Sex Distribution
  • Sex Factors
  • Spain / epidemiology
  • Survival Rate / trends
  • Time Factors