Abstract
Background and aimsFew studies have determined whether the declining incidence of myocardial infarction carries into the current decade, and how it is affected by age and sex. We aimed to determine age- and sex-specific changes in myocardial infarction incidence in Denmark from 2005 through 2021. MethodsFirst-time myocardial infarction admissions in adults aged ≥18 years were identified through Danish nationwide registries. Incidence rates per 100,000 persons with 95% confidence intervals (CI) were calculated across calendar year, sex, and age groups (≤49, 50–69, 70–84, ≥85 years). We also presented incidence rate ratios (IRR) with 95% CIs for 2019–2021 compared to 2005–2007. ResultsFrom January 1, 2005, through August 4, 2021, there were 116,481 incident acute myocardial infarctions in approximately 4.5 million Danes aged ≥18 years. Overall incidence rate of myocardial infarction per 100,000 persons decreased in both sexes from 2005 through 2021 (females: 143 to 80; males: 243 to 174) and across all age groups. The steepest declines in incidence were observed for ages ≥85 years (males: 55%, IRR: 0.45 [0.41–0.49]; females: 58%, IRR: 0.42 [0.39–0.45]) and 70–84 years (males: 46%, IRR: 0.54 [0.52–0.57]; females: 52%, IRR: 0.48 [0.46–0.51]). Rates also declined significantly for ages 50–69 (males: 19%, IRR: 0.81 [0.79–0.84]; females: 17%, IRR: 0.83 [0.78–0.88]) and ≥49 years (males: 30%, IRR: 0.70 [0.64–0.76]; females: 37%, IRR: 0.63 [0.54–0.74]). ConclusionsDeclines in the incidence of myocardial infarction continued into the current decade across age groups and sex. However, significantly steeper absolute and relative declines were observed among the oldest age groups (≥70 years).
Highlights
The incidence of myocardial infarction has declined in various populations since the middle of the previous century [1–6], due to a reduction of traditional risk factors for atherosclerotic cardiovascular disease and establishment of new effective treatments for primary and secondary prevention in randomized trials [7–14]
Few studies have determined whether the declining incidence of myocardial infarction carries into the current decade, and how it is affected by age and sex
We presented characteristics of patients hospitalized with first-time myocardial infarction in 4-year calendar intervals at the date of hospi talization as counts and percentages for categorical variables and me dian with interquartile range (IQR) for age
Summary
The incidence of myocardial infarction has declined in various populations since the middle of the previous century [1–6], due to a reduction of traditional risk factors for atherosclerotic cardiovascular disease and establishment of new effective treatments for primary and secondary prevention in randomized trials [7–14]. The most recent studies of myocardial infarction incidence had follow-up through the mid-2010s [19–22], or reported age- and sex-standardized incidences, not showing the age- and sex-specific developments in the incidence of myocardial infarction [23] It remains unclear whether the declining incidence of myocardial infarction from the 1950s to the mid-2010s have continued in the present decade, and whether they apply to women and the elderly. To address this knowledge gap, we conducted a nationwide, registry-based study of the age- and sex-specific trends in the incidence. Significantly steeper absolute and relative declines were observed among the oldest age groups (≥70 years)
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