Analysis of myocardial infarction incidence and case-fatality in the last three decades in the province of Girona

Anna Camps-Vilaró; Isaac Subirana; Roberto Elosua; Iván Palomo; Juan Sanchis; Helena Tizón-Marcos; Miguel Cainzos-Achirica; Joan Sala; Rafael Masia; Rafel Ramos; Irene R Dégano; Jaume Marrugat

doi:10.1016/j.rec.2023.10.005

Analysis of myocardial infarction incidence and case-fatality in the last three decades in the province of Girona

Rev Esp Cardiol (Engl Ed). 2023 Nov 21:S1885-5857(23)00307-9. doi: 10.1016/j.rec.2023.10.005. Online ahead of print.

[Article in English, Spanish]

Authors

Affiliations

¹ Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Doctoral College, University of Vic-Central University of Catalonia (Uvic-UCC), Vic, Barcelona, Spain.
² Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Grup d'Epidemiologia i Genètica Cardiovascular, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain.
³ Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Doctoral College, University of Vic-Central University of Catalonia (Uvic-UCC), Vic, Barcelona, Spain; Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Barcelona, Spain.
⁴ Centro de Investigación en Trombosis, Departmento de Bioquímica Clínica e Inmunohematología, Escuela de Ciencias de la Salud, Universidad de Talca, Talca, Chile.
⁵ Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Cardiology Department, Hospital Clínic de Valencia, Valencia, Spain.
⁶ Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servei de Cardiologia, Hospital del Mar, Barcelona, Spain.
⁷ Servei de Cardiologia, Hospital del Mar, Barcelona, Spain.
⁸ Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servei de Cardiologia, Hospital Universitari Josep Trueta, Girona, Spain.
⁹ Servei de Cardiologia, Hospital Universitari Josep Trueta, Girona, Spain.
¹⁰ Unitat de Recerca de Medicina Familiar-de Girona, Institut de Recerca en Atenció Primària Jordi Gol, Barcelona, Spain.
¹¹ Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Grup d'Epidemiologia i Genètica Cardiovascular, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Barcelona, Spain. Electronic address: iroman@imim.es.
¹² Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: jmarrugat@regicor.cat.

PMID: 37981192
DOI: 10.1016/j.rec.2023.10.005

Abstract

Introduction and objectives: Myocardial infarction (MI) incidence and case fatality trends are highly informative but relatively untested at the population level. The objective of this work was to estimate MI incidence and case fatality in the Girona population aged 35-74 years, and to determine their 30-year trends (1990-2019).

Methods: The REGICOR (Girona Heart Registry) monitored MI incidence and case fatality rates from 1990 to 2008. For the period 2008 to 2019, we linked discharges from Girona hospitals (n=4 974 977) and mortality registry (n=70 405) during this period. Our linkage algorithm selected key MI diagnostic codes and removed duplicates. Estimates from the linkage algorithm and the REGICOR registry were compared using chi-square tests for overlapping years (2008-2009). We estimated the annual percent change (APC) of standardized MI incidence and 28-day case fatality, and analyzed their trends using joinpoint regression.

Results: MI incidence and case fatality estimates were similar in the linkage algorithm and the REGICOR registry. We observed significant decreasing trends in the incidence of MI. The trend was APC, -0.96% (95% confidence interval (95%CI), -1.4 to -0.53) in women from 1990 to 2019 and -4.2% (95%CI, -5.5 to -3.0) in men from 1994 to 2019. The largest decrease in case fatality was -3.8% (95%CI, -5.1 to -2.5) from 1995 to 2003 in women and -2.4% (95%CI, -2.9 to -1.9) from 1995 to 2004 in men, mainly due to prehospital case fatality declines: -1.8% (95%CI, -2.6 to -1.1) in men and -3.2% (95%CI, -4.6 to -1.8) in women.

Conclusions: In Girona, MI incidence and case fatality decreased between 1990 and 2019. The incidence showed a slow but continuous decrease while case fatality only stabilized in the last decade, particularly in women.

Keywords: Algoritmo de enlace de datos; Case fatality; Data-linkage algorithm; Incidence; Incidencia; Infarto agudo de miocardio; Letalidad; Myocardial infarction.