Abstract 2641: Comparative Incidence, Case-Fatality and Survival Rates of Stroke and Acute Myocardial Infarction. The Dijon Vascular (DIVA) Project

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Arnaud Gentil ◽  
Yannick Bejot ◽  
Luc Lorgis ◽  
Jerome Durier ◽  
Marianne Zeller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Care Organizations ◽  
Large Population ◽  
Survival Rates ◽  
Case Fatality ◽  
Clinical Trial Design ◽  
Population Based ◽  
Incidence Rates ◽  
Cerebrovascular Events

Acute coronary and cerebrovascular events share common underlying arterial pathology. Although some studies have evaluated the epidemiology of these two diseases, many of them were limited by being conducted on selected populations. The aim of the Dijon Vascular Project was to evaluate the epidemiology of both stroke and acute myocardial infarction from a large population-based study and over a long period. We prospectively assessed all first-ever cases of stroke and acute myocardial infarction (AMI) in a population of 151,846 in the city of Dijon, France, from 2001 to 2006. The 30-day case fatality rates were assessed in both groups. We recorded 1660 events, including 1020 (61.4 %) strokes and 640 AMI (38.6 %). The crude incidence of stroke was 112 / 100,000 / year while that of AMI was 70.2 / 100 000 / year. Incidence rates of the two diseases rose steeply with age. In women, the incidence of stroke was higher than that of AMI, in particular at 65 years and older. In men, the incidence of stroke was lower than that of AMI below 55 years, was similar between 55 and 65 years and higher above 65 years. Case-fatality rates at 30 days were similar for stroke and AMI. Our findings confirm that the annual incidence of stroke is higher than that of AMI except in young men. These data implications for prevention strategies, acute care, clinical trial design for future therapies and health-care organizations.

Secular Trends of Stroke Epidemiology in Örebro, Sweden, 2017 Compared to the Trends in 1999: A Population-Based Study

2019 ◽  
Vol 48 (3-6) ◽  
pp. 149-156 ◽  
Author(s):  
Peter Appelros
Keyword(s):  
Length Of Stay ◽  
Incidence Study ◽  
Large Population ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Stroke Severity ◽  
Stroke Incidence ◽  
Preventive Medication

Background and Purpose: A stroke incidence study in ­Örebro, situated in Southern Sweden, that was carried out in 1999 showed high incidence rates. Since then, in many Western countries, declining incidence rates have been observed. The main purpose of this study is to examine whether there have been any changes in stroke incidence in the city of ­Örebro between 1999 and 2017. Secondary purposes are to show trends in stroke severity, length of stay and case fatality (CF). Methods: The criterion of an “ideal” stroke incidence study was used in both the 1999 and the present investigation. These criteria include uniform diagnostics, case ascertainment including strokes managed outside the hospital, and the use of several overlapping sources, prospective design, well-defined denominator, and a large population. Results: The overall stroke incidence rate of first ever stroke (adjusted to the 2013 European population) dropped from 346/100,000 (95% CI 314–380) to 168/100,000 (95% CI 148–190). Stroke severity declined from a median of 6 to 4 points on the National Institute of Health Stroke scale. CF within 28 days also declined from 19 to 16% (n.s.). Median length-of-stay in hospital was 16 days in 1999, and 10 days in 2017. Twenty-one per cent of all kinds of stroke were recurrent (not included in the above results). Conclusions: During the years between 1999 and 2017, there have been reductions in stroke incidence, severity and mortality. The explanation is most likely to be found in the prevalence of risk factors and how they are treated. The use of antihypertensives and statins has increased, corresponding to lower levels of blood pressure and cholesterol in the population. The use of anticoagulants in patients with atrial fibrillation has increased. Cigarette smoking has decreased. These are encouraging results that show that preventive medication and public health measures work in practice.

scholarly journals Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases

Blood ◽  
2009 ◽  
Vol 113 (21) ◽  
pp. 5064-5073 ◽  
Author(s):  
Porcia T. Bradford ◽  
Susan S. Devesa ◽  
William F. Anderson ◽  
Jorge R. Toro
Keyword(s):  
United States ◽  
Large Population ◽  
Survival Rates ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
T Cell Lymphomas ◽  
Cutaneous Lymphomas ◽  
Distinct Disease ◽  
Asian Pacific

Abstract There have been no prior large population-based studies focusing on cutaneous lymphomas (CL) in the United States. Using the Surveillance, Epidemiology and End Results (SEER) program data, we analyzed age-adjusted CL incidence rates (IRs) and survival rates by sex and race/ethnicity. There were 3884 CLs diagnosed during 2001-2005. Cutaneous T-cell lymphomas (CTCLs) accounted for 71% (age-adjusted incidence rate [IR] = 7.7/1 000 000 person-years), whereas cutaneous B-cell lymphomas(CBCLs) accounted for 29% (IR = 3.1/1 000 000 person-years). Males had a statistically significant higher IR of CL than females (14.0 vs 8.2/1 000 000 person-years, respectively; male-female IR ratio [M/F IRR] = 1.72; P < .001). CL IRs were highest among blacks and non-Hispanic whites (both 11.5/1 000 000 person-years), followed by Hispanic whites (7.9) and Asian/Pacific Islanders (7.1). The CTCL IR was highest among blacks (10.0/1 000 000 person-years), whereas the CBCL IR was highest among non-Hispanic whites (3.5). Over the past 25 years, the CL IR increased from 5.0/1 000 000 person-years during 1980-1982 to 14.3 during 2001-2003. During 2004-2005, the CL IR was 12.7. This recent apparent change could be incomplete case ascertainment or potential leveling off of IRs. CLs rates vary markedly by race and sex, supporting the notion that they represent distinct disease entities.

Abstract P371: Twenty-Five-Year (1986-2011) Trends in the Incidence and In-Hospital Case-fatality Rates of Stroke Complicating Acute Myocardial Infarction

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Essa Hariri ◽  
Mayra Tisminetzky ◽  
Robert Goldberg
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Stroke ◽  
Case Fatality ◽  
Incidence Rates ◽  
Index Hospitalization ◽  
Optimal Care ◽  
Significant Burden ◽  
History Of ◽  
Study Population

Introduction: Stroke after acute myocardial infarction (AMI) is an important complication resulting in increased morbidity and mortality. However, limited long-term trends data are available about the incidence and death rates associated with this serious complication. Objective: The aim of this study is to examine the 25-year trends in the incidence rates and outcomes of initial episodes of stroke complicating AMI. Hypothesis: We hypothesize that the incidence and outcomes of stroke complicating AMI would decrease over time with recent advances in the management of both diseases. Methods: The study population consisted of 11,433 adults hospitalized with validated AMI at all 11 medical centers in central Massachusetts on a biennial basis between 1986-2011. Results: Of 11,436 patients (mean age = 69 years; 42% female) without a history of stroke hospitalized with confirmed AMI, 159 patients (1.4%) experienced an acute stroke during their index hospitalization. The proportion of patients with AMI who developed a stroke increased through the 1990s but declined slightly thereafter (Figure 1). Patients who experienced an acute stroke were significantly older, more likely to be female, had a previous AMI, had a significant burden of comorbidities, and were more likely to have developed atrial fibrillation, heart failure, and have died (32.1% versus 10.8%; p<0.001) during their index hospitalization compared with patients who did not develop a stroke. Patients developing a stroke in the most recent years (2003-2011) were 5 times more likely to have died during hospitalization compared to those who did not develop a stroke (OR, 5.05; 95% CI, 2.34-10.90). Conclusions: In conclusion, the incidence rates of acute stroke complicating AMI remained relatively stable during the years under study but with an increased likelihood of dying during hospitalization. Better characterization of factors associated with the risk of stroke remains important for the more optimal care of this vulnerable population.

Abstract 107: Decade Long Trends (1999 - 2009) in Pre-hospital Delay and Short-term Mortality in Patients Hospitalized for Acute Myocardial Infarction - The Worcester Heart Attack Study

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Nathaniel Erskine ◽  
Jorge Yarzebski ◽  
Darleen M Lessard ◽  
Joel M Gore ◽  
Robert J Goldberg
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Medical Care ◽  
Case Fatality ◽  
Population Based ◽  
Short Term ◽  
Population Based Study ◽  
Medical Centers ◽  
Delay Times ◽  
Short Term Mortality

Objective: Patients experiencing signs and symptoms of an acute myocardial infarction (AMI) require prompt evaluation and treatment. There are little contemporary data, however, available on how the extent of delay between the onset of acute coronary symptoms and hospital presentation may impact short-term mortality. The purpose of this population-based study was to examine the relationship between extent of pre-hospital delay with hospital case-fatality rates (HCFRs) and 30-day post-admission mortality rates (PAMRs) among patients hospitalized with validated AMI in all central Massachusetts medical centers, and trends over time therein. Methods: We examined the medical records of residents of the Worcester, MA, metropolitan area hospitalized with a confirmed AMI at all 11 central MA medical centers on a biennial basis between 1999 and 2009 (n = 6,017). Information on patient’s demographic, medical history, clinical characteristics, and time of acute symptom onset and hospital arrival was abstracted. Results: Hospital medical record data on pre-hospital delay were available for 2,913 (48%) subjects of whom their mean age was 68 years, 38% were female, and 90% were Caucasian. The mean and median pre-hospital delay times were 4.0 hours and 2.0 hours, respectively, with little change noted in these times between 1999 and 2009. Patients who reported pre-hospital delay times greater than two hours were more likely to be older, female, and have a history of heart failure or diabetes mellitus as compared with patients who delayed seeking medical care by less than 2 hours. The overall HCFR was 6.6% and 30-day PAMR was 9.4%. The average HCFRs and 30-day PAMRs varied slightly between those with delay times of less than 2 hours (6.5%, 9.2%), 2 to 4 hours (6.3%, 8.6%), and greater than 4 hours (7.0%, 10.6%). No statistically significant changes in HCFRs and 30-day PAMRs were observed as pre-hospital delay times increased. Analyses of our principal study outcomes according to type of AMI (e.g., STEMI and NSTEMI) are ongoing and will be presented subsequently. Conclusions: This population-based study of residents of central MA hospitalized with AMI in all metropolitan Worcester medical centers showed little change in average and median pre-hospital delays between 1999 and 2009. Both the HCFRs and 30-day PAMRs were not significantly increased with greater durations of pre-hospital delay possibly due to potential confounders such as symptom severity. Our preliminary results suggest the need to further investigate trends in pre-hospital delay and short-term mortality, including patients who die in the community before receiving acute medical care.

P5012Ten-year trends and outcomes in cardiogenic shock related to first-time acute myocardial infarction: a nationwide population-based cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Dam Lauridsen ◽  
R Rorth ◽  
M G Lindholm ◽  
J Kjaergaard ◽  
M Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Cardiogenic Shock ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cox Regression Analysis ◽  
Incidence And Mortality ◽  
First Time

Abstract Introduction Despite declining incidence and mortality for acute myocardial infarction, cardiogenic shock remains a severe complication with poor in-hospital prognosis. Little is known about the temporal trends in hospitalization with acute myocardial infarction-related cardiogenic shock (AMI-CS) and the long-term prognosis. Purpose We aimed to investigate the hospitalization with first-time AMI-CS and subsequent 1-year mortality. Methods In this nationwide Danish cohort study we identified from 2005 through 2015 patients with first-time acute myocardial infarction and compared those with and without cardiogenic shock (defined by either an ICD-10 diagnosis code with cardiogenic shock and/or procedure code with inotropes or vasopressors). Patient characteristics and 1-year mortality were compared between groups using Kaplan-Meier plots and multivariable Cox regression analysis. Results We included 96,030 patients with acute myocardial infarction of whom 5.4% had cardiogenic shock. Median age was 69.7 years (IQR 59.0–80.1) and 37.5% were female among those without cardiogenic shock and 70.2 years (IQR 61.4–78.1) and 33.0% were female in those with cardiogenic shock. We observed no change in hospitalization with cardiogenic shock during the study period (5.45% in 2006 vs 5.54% for 2016, P for difference 0.6). One-year mortality was higher among those with cardiogenic shock relative those without (See Figure). Crude 1-year mortality risk associated with AMI decreased over time from 23.4% in 2006 vs 11.5% in 2016 (p for difference <0.0001) and this was consistent for AMI patients without CS (21.4% in 2006 vs 9.4% in 2016, p<0.0001) and patients with AMI-CS (58.1% in 2006 vs 46.2% in 2016, p<0.0001). When comparing patients with AMI-CS to those without in multivariable analysis, AMI-CS was associated with a 1-year mortality hazard ratio of 5.38 (95% CI 5.17–6.61)). Cumulative 1-year mortality among patien Conclusion In a large population-based setting, this study suggests that the hospitalization for first-time AMI-CS was stable from 2005 through 2015, while mortality improved with time. However, the grave outcome related to AMI-CS remains with a 5-times higher mortality compared to AMI patients without CS. Acknowledgement/Funding Rigshospitalets Research Fund

scholarly journals Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study

2010 ◽  
Vol 69 (6) ◽  
pp. 1162-1164 ◽  
Author(s):  
Mary A De Vera ◽  
M Mushfiqur Rahman ◽  
Vidula Bhole ◽  
Jacek A Kopec ◽  
Hyon K Choi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Elderly Women ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Prescription Drug Use ◽  
Increased Risk

BackgroundMen with gout have been found to have an increased risk of acute myocardial infarction (AMI), but no corresponding data are available among women.ObjectiveTo evaluate the potential independent association between gout and the risk of AMI among elderly women, aged ≥65 years.MethodsA population-based cohort study was conducted using the British Columbia Linked Health Database and compared incidence rates of AMI between 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease. Cox proportional hazards models stratified by gender were used to estimate the relative risk (RR) for AMI, adjusting for age, comorbidities and prescription drug use.ResultsOver a 7-year median follow-up, 3268 incident AMI cases, were identified, 996 among women. Compared with women without gout, the multivariate RRs among women with gout were 1.39 (95% CI 1.20 to 1.61) for all AMI and 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI. These RRs were significantly larger than those among men (multivariate RRs for all AMI and non-fatal AMI, 1.11 and 1.11; p values for interaction, 0.003 and 0.005, respectively).ConclusionThese population-based data suggest that women with gout have an increased risk for AMI and the magnitude of excess risk is higher than in men.

Changing prevalence of indolent lymphoid malignancies among the elderly

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7579-7579
Author(s):  
W. T. Swenson
Keyword(s):  
Disease Burden ◽  
Large Population ◽  
Survival Rates ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Prevalence Rates ◽  
Annual Percent Change ◽  
Lymphoid Malignancies ◽  
Diagnostic Codes

7579 Background: Reported changes in incidence rates and improved survival rates among patients with common indolent B-cell lymphoid malignancies have potential implications for increased disease burden among the elderly. This study examines incidence, survival, and prevalence rates of elderly patients with follicular lymphoma (FL) and CLL/SLL using a large population based database. The indolent and incurable nature of these diseases makes the prevalence rate a good indicator of total disease burden. Methods: The SEER 9 public use database was analyzed using SEER*Stat software version 6.1.4. Subjects were identified by ICD-O-3 diagnostic codes. Incidence rates and trends (from 1973 to 2002) were calculated (per 100,000 population) and were age-adjusted to the 2000 US standard population. Survival rates were calculated for patients diagnosed during the periods 1980–1985 and 1990–1995. Prevalence rates include patients diagnosed within 15 years prior to the prevalence date (15-year limited prevalence). Results: Annual percent change of incidence rate (per 100,000) among patients ≥65 years (from 1973 to 2002) was 2.76 (95% CI: 1.92, 3.60) for FL and -0.18 (95% CI: -0.47, 0.11) for CLL/SLL. Survival rates for patients ≥65 years was improved for both FL and CLL/SLL. Among patients with FL diagnosed between 1975–1980 and 1990–1995, 5-year survival rates were 42.2% (95% CI: 38.8, 45.6) and 50.3% (95% CI: 47.9, 52.7). Among patients with CLL diagnosed between 1975–1980 and 1990–1995, 5-year survival rates were 40.6% (95% CI: 38.8, 42.4) and 50.4% (95% CI: 48.9, 51.9). Prevalence percent increased for FL patients among ages 65–74 years, 75–84 years, and ≥85 years. Prevalence percents were unchanged among CLL/SLL patients. Conclusions: Increased FL incidence and increased survival rates have resulted in a growing disease burden among the elderly over the last decade; the prevalence of CLL/SLL has remained static. [Table: see text] No significant financial relationships to disclose.

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