Abstract
Background: We have previously demonstrated the trends for increasing incidence of acute myocardial infarction (AMI) and decreasing incidence of in-hospital mortality in Japan between the late 1970s and 2000s. However, the temporal trends in incidence and mortality of AMI in the 21st century in Japan remain to be elucidated since the previous report. Methods and Results: Miyagi AMI Registry Study is a prospective and observational study where all AMI patients in the Miyagi prefecture (2.32 million populations) have been registered. In the present study, we divided a total of 27,220 AMI patients (male/female 19,818/7,402) into 4 age groups (≤59, 60-69, 70-79 and ≥80 years) by sex, and examined decennial trends during the last 30 years (1985-1994, 1995-2004 and 2005-2014) in terms of incidence and in-hospital mortality of AMI. Statistical analysis was performed by using the piecewise linear regression model. In patients aged ≤59 years of both sexes, increasing trend in the incidence of AMI was consistently noted throughout the last 30 years (P<0.01 in both sexes), whereas in male patients aged 60-69 years, the incidence of AMI was unaltered during the study period (P=0.11). On the other hand, in the remaining groups, including males aged 70-79 and ≥80 years and females aged 60-69, 70-79 or ≥80 years, the incidence of AMI showed a significant trend of decrease in the last decade (P<0.01 in all groups) (Figure). In-hospital cardiac mortality was also significantly decreased during 1985-1994 in all age groups in both sexes (P<0.01 in all groups), whereas in the last two decades, no such trend of in-hospital cardiac mortality was noted irrespective of sex or age. Conclusions: These results indicate the temporal trends in incidence of AMI in Japan, including the increases in younger ages and the decreases in elderly ages, providing a clue to further improve emergent care for AMI.
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