Incident Fatal Myocardial Infarction Research Articles

Future burden of myocardial infarction in Australia: impact on health outcomes between 2019 and 2038.

Myocardial infarction (MI) remains a major health burden in Australia. Yet the future burden of MI has not been extensively studied for the Australian population. A multistate lifetable model was constructed to estimate the lifetime risk of MI and project the health burden of MI for the Australian population aged between 40 and 100 years over a 20-year period (2019-2038). Data for the model were primarily sourced from the Victorian-linked dataset and supplemented with other national data. The lifetime risk of MI at age 40 was estimated as 24.4% for males and 13.2% for females in 2018. From 2019 to 2038, 891 142 Australians were projected to develop incident MI. By 2038, the model estimated there would be 702226 people with prevalent MI, 51262 incident non-fatal MI, and 3717 incident fatal MI; these numbers represent a significant increase compared to the 2019 estimates, with a 27.0% (148827), 62.0% (19629), and 104.7% (1901) rise, respectively. Projected years of life lived (YLL) (5% discount) accrued by the Australian population was 174795232 (84356304 in males and 90438928 in females), with 7 657 423 YLL among people with MI (4 997 009 in males and 2 660 414 in females). The burden of MI was projected to increase between 2019 and 2038 in Australia. The outcomes of the model provide important information for decision-makers to prioritize population-wide prevention strategies to reduce the burden of MI.

Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study.

Background:Air pollution exposure has been linked to coronary heart disease, although evidence on and myocardial infarction (MI) incidence is mixed.Objectives:This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise.Methods:We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses ( of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter (), , nitrogen dioxide (), and nitrogen oxides () at the nurses’ residences since 1990 ( and ) or 1970 ( and ) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of and , with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average ().Results:Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and for , , , and , respectively. In Model 1, we observed a positive association between a 3-y running mean of and an overall incident MI with an (95% CI: 1.07, 1.35), which attenuated to (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of , with an (95% CI: 1.33, 2.13), which attenuated to (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for , with 3-y, Model 2 estimates for overall and fatal incident MI of (95% CI: 0.91, 1.23) and (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for or . For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure.Conclusions:We found no association between long-term exposure to , , , or and overall MI incidence, but we observed positive associations for and with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818

Finalists, The Jeremiah and Rose Stamler Research Award for New Investigators Fatty fish consumption and ischemic heart disease mortality in older adults: The Cardiovascular Health Study

P01 OBJECTIVE. To assess whether dietary intake of fatty fish is associated with a reduced risk of ischemic heart disease mortality in older adults. BACKGROUND. Dietary intake of fatty fish has been associated with a reduced risk of fatal ischemic heart disease in middle-aged men and women. This association, however, has not been specifically evaluated in older adults. METHODS. In 3968 men and women ≥ age 65 enrolled in the Cardiovascular Health Study and free of known cardiovascular disease at baseline, dietary intake of fish (fried fish, tuna fish, and other fish) was assessed through a detailed picture-sort food frequency questionnaire. In a subset of 348 persons, dietary intake of tuna and other fish combined (“fatty fish”) correlated with plasma phospholipid levels of combined docosahexaenoic acid (DHA, 22:6 n-3)) and eicosapentaenoic acid (EPA, 20:5 n-3) (r = 0.40, p < 0.001); intake of fried fish did not correlate with plasma phospholipid levels of these long-chain n-3 fatty acids (r = 0.05, p = 0.37). Participants were prospectively followed for a mean period of 6.8 years for death from ischemic heart disease (incident fatal myocardial infarction [MI] plus coronary heart disease death) and nonfatal MI. FINDINGS. Compared to intake of less than one serving of fatty fish per week, intake of at least one serving of fatty fish per week was associated with a 35% lower risk of death from ischemic heart disease (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.45 to 0.94) but was not associated with a lower risk of nonfatal MI (HR 0.86; 95% CI 0.64 to 1.15), after adjustment for age, gender, diabetes, smoking status, education, and total caloric intake. CONCLUSIONS. These findings suggest that consumption of at least one serving of fatty fish per week is associated with a lower risk of death from ischemic heart disease in persons aged 65 years and older.