Abstract 13165: Increasing Incidence Rates and High Case Fatality Rates for Acute Myocardial Infarction in the Caribbean Island of Barbados

Abstract

Introduction: The Caribbean sub-region has the highest rates of cardiovascular disease in the Region of the Americas. We present data from one of the few population-based registries in the region - the Barbados National Registry for NCDs (BNR). We describe trends in incidence and case fatality rates for acute myocardial infarction(MI) in the high income small island developing state of Barbados. Hypothesis: Myocardial infarction age-standardized incidence rates (ASIRs) are increasing. Methods: Data from the BNR were collected prospectively from charts of patients diagnosed with acute myocardial infarction from all private and public hospitals for the period 2010-2019. Out-of-hospital deaths and in-hospital deaths within 24 hours, were identified through the national vital registration department. Cases are defined in accordance with the Universal Definition of Myocardial Infarctions published by the American Heart Association. Population estimates were obtained from the United Nation World Population Prospects. We calculated incidence rates by sex, age-standardized to the World Health Organization 2000 population and assessed trends in case fatality rates for those admitted to hospital. Results: For the period 2010-2019, 4065 cases of as myocardial infarction (MI) were registered by BNR. Numbers of cases ranged from 294 in 2011 to 547 in 2019. The 3-year average for 2014 - 2016 is 391 cases versus 499 cases for 2017 - 2019 - a 28% increase in new cases. ASIRs increased from 67 per 100,000 (95%UI 59 to 75) in 2011 to 123 per 100,000 (95%UI 113 to 135) in 2019. ASIRs were consistently higher in men ranging from 83 per 100,00 (95% UI 71 - 98) to 120 (95% UI 106 to 136) while rates in women ranged from 43 per 100,000 95% CI (35 - 53) to 83 per 100,000 (73 - 95). The in-hospital case fatality rate (CFR) was 25% in 2019, ranging from 15% in 2011 to 31% in 2014. Overall, CFR was higher in women (24%) versus men (19%) and this was true in 9/10 years. Conclusions: Despite its status as a high income country, ASIRs for MIs in Barbados are increasing while case fatality rates are more than twice as high as rates found in developed countries.