Temporal trends in the prevalence of cardiovascular and non-cardiovascular comorbidities in patients presenting with acute myocardial infarction: Insights from the AMIS Plus registry

Abstract

Abstract Background Little is known about temporal trends in the prevalence of cardiovascular and non-cardiovascular comorbidities in patients presenting with acute myocardial infarction (AMI). Methods AMIS Plus registry patients enrolled between 2004 and 2021 were stratified based on comorbidities in 3 groups: (1) «cardiovascular comorbidity»: at least one among past history of myocardial infarction, coronary artery bypass grafting or percutaneous coronary intervention, heart failure, peripheral vascular disease, cerebrovascular disease, or atrial fibrillation; (2) «non-cardiovascular comorbidity»: at least one among dementia, chronic lung disease, connective tissue disease, peptic ulcer disease, moderate or severe renal disease, diabetes, liver disease, or cancer disease; and (3) «any comorbidity»: at least one of the mentioned comorbidities. Prevalence and mortality were analysed according to the type of comorbidity in 2-year periods and stratified by sex. Temporal trends were analysed using the Mantel-Haenszel linear-by-linear association Chi-squared test. Results Among the 48’848 patients enrolled, 24’215 (49.6%) had at least one comorbidity. Of these, 17’441 (72.0%) were male and 6’774 (28.0%) female. Over the years, there was a significant decrease in the prevalence of «any comorbidity» (p<0.001) as well as «cardiovascular comorbidity» (p<0.001). A significant decrease in the prevalence of «any comorbidity» as well as «cardiovascular comorbidity» was detected for both sexes. With respect to the prevalence of «non-cardiovascular comorbidity», a significant reduction over time was observed in men but not in women. The reduction of in-hospital mortality over time was significant across all groups, overall and for both sexes individually. Conclusions Over more than a decade, a significant reduction in the prevalence of comorbidities was observed in patients presenting with AMI, with the exception of non-cardiovascular comorbidities in women. This reduction may have contributed, in addition to the improvements in pharmacologic treatments as well as in revascularization, to the improved survival observed over time.Temporal trends of comorbidities