Abstract
BackgroundAcute and chronic coronary heart disease (CHD) pose different burdens on health-care services and require different prevention and treatment strategies. Trends in acute and chronic CHD event rates can guide service implementation. This study evaluated changes in acute and chronic CHD event rates in metropolitan and regional/remote Victoria.MethodsVictorian hospital admitted episodes with a principal diagnosis of acute CHD or chronic CHD were identified from 2005 to 2012. Acute and chronic CHD age-standardised event rates were calculated in metropolitan and regional/remote Victoria. Poisson log-link linear regression was used to estimate annual change in acute and chronic CHD event rates.ResultsAcute CHD age-standardised event rates decreased annually by 2.9 % (95 % CI, −4.3 to −1.4 %) in metropolitan Victoria and 1.7 % (95 % CI, −3.2 to −0.1 %) in regional/remote Victoria. In comparison, chronic CHD age-standardised event rates increased annually by 4.8 % (95 % CI, +3.0 to +6.5 %) in metropolitan Victoria and 3.1 % (95 % CI, +1.3 to +4.9 %) in regional/remote Victoria. On average, age-standardised event rates for regional/remote Victoria were 30.3 % (95 % CI, 23.5 to 37.2 %) higher for acute CHD and 55.3 % (95 % CI, 47.1 to 63.5 %) higher for chronic CHD compared to metropolitan Victoria from 2005 to 2012.ConclusionAnnual decreases in acute CHD age-standardised event rates might reflect improvements in primary prevention, while annual increases in chronic CHD age-standardised event rates suggest a need to improve secondary prevention strategies. Consistently higher acute and chronic CHD age-standardised event rates were evident in regional/remote Victoria compared to metropolitan Victoria from 2005 to 2012.
Highlights
Acute and chronic coronary heart disease (CHD) pose different burdens on health-care services and require different prevention and treatment strategies
There is a paucity of evidence investigating the incidence of both acute CHD and chronic CHD because the majority of international studies have investigated the incidence of acute myocardial infarction (AMI) only or a definition of CHD that encompasses all of angina pectoris, AMI and chronic CHD [6,7,8,9]
An estimated -2.9 % annual change in acute CHD age-standardised event rates were found in metropolitan Victoria while a −1.7 % annual change in acute CHD age-standardised event rates were found in regional/ remote Victoria
Summary
Acute and chronic coronary heart disease (CHD) pose different burdens on health-care services and require different prevention and treatment strategies. Trends in acute and chronic CHD event rates can guide service implementation. This study evaluated changes in acute and chronic CHD event rates in metropolitan and regional/remote Victoria. Coronary heart disease (CHD) is the leading cause of death and a significant contributor to health-care expenditure in Australia and around the world [1, 2]. CHD accounted for more than $2 billion of health-care expenditure in Australia in 2008/09, of which 75 % was directed towards hospital-admitted patient services [3]. Acute CHD, angina pectoris or acute myocardial infarction (AMI), and chronic CHD pose different burdens on health-care services. There is a paucity of evidence investigating the incidence of both acute CHD and chronic CHD because the majority of international studies have investigated the incidence of AMI only or a definition of CHD that encompasses all of angina pectoris, AMI and chronic CHD [6,7,8,9]
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