Variation in the Use of Ticagrelor after Myocardial Infarction Across NZ: ANZACS-QI Registry Data

Abstract

recent trends in first and recurrent ischaemic heart disease (IHD) hospitalisations in New Zealand. Methods:Anonymouspatient-linkageof routinely collected data was used to identify all ICD-coded IHD hospitalisations between 1 January 2005 and 31 December 2013. First and recurrent hospitalisations were differentiated using a ten-year look-back period. Age-standardised hospitalisation rateswere calculated for each calendar year and trends compared by sex, agegroupand IHDsubtype.Negativebinomial regressionwas used to estimate changes in rates, adjusted for age and year. Results: Between 2005 and 2013 there were 183,581 IHD hospitalisations. During this time hospitalisation rates declined in both men and women and in all age groups, but the reduction was steeper for recurrent events. By 2013 recurrent events accounted for approximately half of all IHD hospitalisations. Ageand year-adjusted annual percent changes for men and women ranged from -1.5 to -2.7% for first events and -3.2 to -4.4% for recurrent events. Among IHD subtypes, annual percent changes were greatest for unstable angina (-3.0 to -6.4% for first and -7.2 to -9.8% for recurrent events) and non-ST elevationmyocardial infarction (-2.2 to -2.5% for first and -3.5 to -4.1% for recurrent events). Conclusion: The decline in IHD hospitalisations observed between 2005 and 2013 was greatest in people with prior IHD, suggesting that in-hospital management and long-term secondary prevention have been effective in reducing recurrent ischaemic events.