scholarly journals Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project

2018 ◽  
Vol 25 (10) ◽  
pp. 1031-1039 ◽  
Author(s):  
Gerhard Sulo ◽  
Jannicke Igland ◽  
Stein Emil Vollset ◽  
Marta Ebbing ◽  
Grace M Egeland ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Incidence Rates ◽  
Myocardial Infarctions ◽  
Men And Women

Background We updated the information on trends of incident acute myocardial infarction in Norway, focusing on whether the observed trends during 2001–2009 continued throughout 2014. Methods All incident (first) acute myocardial infarctions in Norwegian residents age 25 years and older were identified in the Cardiovascular Disease in Norway 1994–2014 project. We analysed overall and age group-specific (25–64 years, 65–84 years and 85 + years) trends by gender using Poisson regression analyses and report the average annual changes in rates with their 95% confidence intervals. Results During 2001–2014, 221,684 incident acute myocardial infarctions (59.4% men) were identified. Hospitalised cases accounted for 79.9% of all incident acute myocardial infarctions. Overall, incident acute myocardial infarction rates declined on average 2.6% per year (incidence rate ratio 0.974, 95% confidence interval 0.972–0.977) in men and 2.8% per year (incidence rate ratio 0.972, 95% confidence interval 0.971–0.974) in women, contributed by declining rates of hospitalisations (1.8% and 1.9% per year in men and women, respectively) and deaths (6.0% and 5.8% per year in men and women, respectively). Declining rates were observed in all three age groups. The overall acute myocardial infarction incidence rates continued to decline from 2009 onwards, with a steeper decline compared to 2001–2009. During 2009–2014, gender-adjusted acute myocardial infarction incidence among adults age 25–44 years declined 5.3% per year, contributed mostly by declines in hospitalisation rates (5.1% per year). Conclusion Acute myocardial infarction incidence rates continued to decline after 2009 in Norway in both men and women. The decline started to involve individuals aged 25–44 years, marking a turning point in the previously reported stagnation of rates during 2001–2009.

Gender Differences in Anterior Cruciate Ligament Injury vary with Activity

2007 ◽  
Vol 35 (10) ◽  
pp. 1635-1642 ◽  
Author(s):  
Sally B. Mountcastle ◽  
Matthew Posner ◽  
John F. Kragh ◽  
Dean C. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Men And Women ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background Previous studies have shown that women involved in similar activities as men are at increased risk for anterior cruciate ligament injuries. Hypothesis The incidence rate of complete anterior cruciate ligament tears for men and women in our athletic, college-aged population is similar. Study Design Descriptive epidemiology study. Methods Students graduating in class years 1994 to 2003 at our institution who sustained complete anterior cruciate ligament tears were assessed for mechanism of injury and type of sport played at time of injury. We calculated the incidence proportion, an estimation of risk, by gender and class year, and the incidence proportion ratio comparing men and women by class year. We also calculated incidence rates by gender and type of sport played and incidence rate ratios comparing men and women. Results There were 353 anterior cruciate ligament injuries in the 10 classes studied. We found an overall, 4-year incidence proportion of 3.24 per 100 (95% confidence interval, 2.89-3.63) for men and 3.51 (95% confidence interval, 2.65-4.65) for women (incidence proportion ratio, 1.09 [95% confidence interval, 0.80-1.47]). The overall anterior cruciate ligament injury rate, excluding male-only sports, was significantly greater in women (incidence rate ratio, 1.51 [95% confidence interval, 1.03-2.21]). We found significantly greater injury rates among women in a gymnastics course (incidence rate ratio, 5.67 [95% confidence interval, 1.99-16.16]), indoor obstacle course test (incidence rate ratio, 3.72 [95% confidence interval, 1.25-11.10]), and basketball (incidence rate ratio, 2.42 [95% confidence interval, 1.05-5.59]). Conclusion We found little gender difference in the overall risk of an anterior cruciate ligament tear; however, there were gender differences in injury rates when specific sports and activities were compared and when male-only sports were removed from the overall rate assessment.

scholarly journals Sex‐Based Differences in Unrecognized Myocardial Infarction

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
M. Yldau van der Ende ◽  
Luis Eduardo Juarez‐Orozco ◽  
Ingmar Waardenburg ◽  
Erik Lipsic ◽  
Remco A. J. Schurer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Myocardial Infarctions ◽  
Missed Opportunities ◽  
Men And Women ◽  
Cardiac Symptoms ◽  
Baseline Visit ◽  
Age And Sex

Background Myocardial infarction is an important cause of morbidity and mortality in both men and women. Atypical or the absence of symptoms, more prevalent among women, may contribute to unrecognized myocardial infarctions and missed opportunities for preventive therapies. The aim of this research is to investigate sex‐based differences of undiagnosed myocardial infarction in the general population. Methods and Results In the Lifelines Cohort Study, all individuals ≥18 years with a normal baseline ECG were followed from baseline visit till first follow‐up visit (≈5 years, n=97 203). Individuals with infarct‐related changes between baseline and follow‐up ECGs were identified. The age‐ and sex‐specific incidence rates were calculated and sex‐specific cardiac symptoms and predictors of unrecognized myocardial infarction were determined. Follow‐up ECG was available after a median of 3.8 (25th and 75th percentile: 3.0–4.6) years. During follow‐up, 198 women experienced myocardial infarction (incidence rate 1.92 per 1000 persons‐years) compared with 365 men (incidence rate 3.30; P <0.001 versus women). In 59 (30%) women, myocardial infarction was unrecognized compared with 60 (16%) men ( P <0.001 versus women). Individuals with unrecognized myocardial infarction less often reported specific cardiac symptoms compared with individuals with recognized myocardial infarction. Predictors of unrecognized myocardial infarction were mainly hypertension, smoking, and higher blood glucose level. Conclusions A substantial proportion of myocardial infarctions are unrecognized, especially in women. Opportunities for secondary preventive therapies remain underutilized if myocardial infarction is unrecognized.

Thirteen-Year Trends in Cardiovascular Risk in Men and Women with Chronic Coronary Syndrome

2021 ◽  
Author(s):  
Kevin Kris Warnakula Olesen ◽  
Esben Skov Jensen ◽  
Christine Gyldenkerne ◽  
Morten Würtz ◽  
Martin Bødtker Mortensen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Incidence Rate ◽  
Cardiac Death ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Men And Women ◽  
Coronary Syndrome ◽  
Adjusted Incidence Rate ◽  
Artery Disease ◽  
Adjusted Incidence

Abstract Aims To examine combined and sex-specific temporal changes in risks of adverse cardiovascular events and coronary revascularization in patients with chronic coronary syndrome undergoing coronary angiography. Methods We included all patients with stable angina pectoris and coronary artery disease examined by coronary angiography in Western Denmark from 2004 to 2016. Patients were stratified by examination year interval: 2004-2006, 2007-2009, 2010-2012, and 2013-2016. Outcomes were two-year risk of myocardial infarction, ischemic stroke, cardiac death, and all-cause death estimated by adjusted incidence rate ratios using patients examined in 2004-2006 as reference. Results A total of 29,471 patients were included, of whom 70% were men. The two-year risk of myocardial infarction (2.8% versus 1.9%, adjusted incidence rate ratio 0.65, 95% CI 0.53-0.81), ischemic stroke (1.8% versus 1.1%, adjusted incidence rate ratio 0.48, 95% CI 0.37-0.64), cardiac death (2.1% versus 0.9%, adjusted incidence rate ratio 0.38, 95% CI 0.29-0.51), and all-cause death (5.0% versus 3.6%, adjusted incidence rate ratio 0.65, 95% CI 0.55-0.76) decreased from the first examination interval (2004-2006) to the last examination interval (2013-2016). Coronary revascularizations also decreased (percutaneous coronary intervention: 51.6% versus 42.5%; coronary artery bypass grafting: 24.6% versus 17.5%). Risk reductions were observed in both men and women, however, women had a lower absolute risk. Conclusion The risk for adverse cardiovascular events decreased substantially in both men and women with chronic coronary syndrome from 2004 to 2016. These results most likely reflect the cumulative effect of improvements in the management of chronic coronary artery disease.

scholarly journals Influence of Smoking on the Location of Acute Myocardial Infarctions

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Rahel Alemu ◽  
Eileen E. Fuller ◽  
John F. Harper ◽  
Mark Feldman
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Anterior Wall ◽  
The Other ◽  
Myocardial Infarctions ◽  
Inferior Wall ◽  
Arterial Circulation ◽  
The Right

Objective. To determine whether there is an association between smoking and the location of acute myocardial infarctions. Methods. Using a cohort from our hospital and published cohorts from Ireland, Uruguay, and Israel, we calculated odds of having an inferior wall as opposed to an anterior wall acute myocardial infarction among smokers and nonsmokers. Results. In our cohort, there was a higher proportion of smokers than nonsmokers in patients with inferior acute myocardial infarctions than in patients with anterior infarctions. This difference was also present in each of the other cohorts. Odds ratios for an inferior versus an anterior acute myocardial infarction among smokers ranged from 1.15 to 2.00 (median odds ratio, 1.32). When the cohorts were combined (), the pooled odds ratio for an inferior as opposed to an anterior acute myocardial infarction among smokers was 1.38 ( confidence interval, 1.20 to 1.58) (). Conclusions. Cigarette smoking increases the risk of inferior wall acute myocardial infarction more than the risk of anterior wall infarction. Smoking thus appears to adversely affect the right coronary arterial circulation to a greater extent than the left coronary arterial circulation by a mechanism not yet understood.

scholarly journals AIDS-related Burkitt lymphoma in the United States: what do age and CD4 lymphocyte patterns tell us about etiology and/or biology?

Blood ◽  
2010 ◽  
Vol 116 (25) ◽  
pp. 5600-5604 ◽  
Author(s):  
Mercy Guech-Ongey ◽  
Edgar P. Simard ◽  
William F. Anderson ◽  
Eric A. Engels ◽  
Kishor Bhatia ◽  
...  
Keyword(s):  
United States ◽  
Incidence Rate ◽  
Burkitt Lymphoma ◽  
Rate Ratio ◽  
Hiv Transmission ◽  
Incidence Rate Ratio ◽  
The United States ◽  
Incidence Rates ◽  
Cd4 Lymphocyte ◽  
Cd4 Lymphocytes

Abstract Trimodal or bimodal age-specific incidence rates for Burkitt lymphoma (BL) were observed in the United States general population, but the role of immunosuppression could not be excluded. Incidence rates, rate ratios, and 95% confidence intervals for BL and other non-Hodgkin lymphoma (NHL), by age and CD4 lymphocyte count categories, were estimated using Poisson regression models using data from the United States HIV/AIDS Cancer Match study (1980-2005). BL incidence was 22 cases per 100 000 person-years and 586 for non-BL NHL. Adjusted BL incidence rate ratio among males was 1.6× that among females and among non-Hispanic blacks, 0.4× that among non-Hispanic whites, but unrelated to HIV-transmission category. Non-BL NHL incidence increased from childhood to adulthood; in contrast, 2 age-specific incidence peaks during the pediatric and adult/geriatric years were observed for BL. Non-BL NHL incidence rose steadily with decreasing CD4 lymphocyte counts; in contrast, BL incidence was lowest among people with ≤ 50 CD4 lymphocytes/μL versus those with ≥ 250 CD4 lymphocytes/μL (incidence rate ratio 0.3 [95% confidence interval = 0.2-0.6]). The bimodal peaks for BL, in contrast to non-BL NHL, suggest effects of noncumulative risk factors at different ages. Underascertainment or biological reasons may account for BL deficit at low CD4 lymphocyte counts.

scholarly journals The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia

2021 ◽  
pp. 000486742110535
Author(s):  
Brian O’Donoghue ◽  
Hannah Collett ◽  
Sophie Boyd ◽  
Yuanna Zhou ◽  
Emily Castagnini ◽  
...  
Keyword(s):  
Young People ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Odds Ratio ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Incident Cases

Objective: The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission). Methods: Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared. Results: Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]). Conclusion: There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.

scholarly journals 555. The Burden of Invasive Staphylococcus Aureus Disease Among Native Americans on the Navajo Nation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S263-S263
Author(s):  
Catherine Sutcliffe ◽  
Lindsay Grant ◽  
Angelina Reid ◽  
Grace K Douglass ◽  
Robert Weatherholtz ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Native American ◽  
Native Americans ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Census Data ◽  
Incidence Rate Ratio ◽  
Incidence Rates ◽  
Navajo Nation ◽  
Significant Difference

Abstract Background Native Americans in the southwestern United States (US) may be at higher risk for invasive infections due to Staphylococcus aureus. The objective of this study was to determine the burden of invasive S. aureus among Native Americans on the Navajo Nation. Methods Prospective population and laboratory-based surveillance for invasive S. aureus infections was conducted from May 2016 through April 2018. A case was defined as a Native American individual living on or around the Navajo Nation with S. aureus isolated from a normally sterile body site. Incidence rates were calculated using the Indian Health Service User Population from 2016 and 2017 as the denominators for Years 1 and 2, respectively. Age-standardized incidence rates were calculated using US Census data from 2015 as the reference group. Results 363 cases were identified (Year 1: 159; Year 2: 204). Most cases were adults (96.9%; median age: 56.0 years) and had ≥1 underlying medical condition (94.5%), of which the most common were diabetes (63.2%), hypertension (39.1%), and obesity (37.2%). 38.0% of cases were categorized as community acquired and 28.7% of infections were methicillin-resistant (MRSA). 83.2% of cases were hospitalized, 10.7% required amputation, and 6.5% died within 30 days of the initial culture. The overall incidence of invasive S. aureus was 74.4 per 100,000 persons (95% confidence interval [CI]: 67.1, 82.4) with a significantly higher incidence in the second year (Year 1: 64.9; Year 2: 84.0; incidence rate ratio: 1.29; 95% CI: 1.05, 1.59). The overall incidence of invasive MRSA was 21.3 per 100,000 persons (95% CI: 17.6, 25.8) with no significant difference by year (Year 1: 21.2; Year 2: 21.4; incidence rate ratio: 1.01; 95% CI: 0.69, 1.48). The incidence of invasive S. aureus and MRSA increased with age and was highest among individuals ≥65 years of age. The overall age-standardized incidence of invasive MRSA was 25.9 per 100,000 persons (Year 1: 26.0; Year 2: 25.7; for comparison US 2015 general population: 18.8 per 100,000 persons). Conclusion The Navajo Nation has a higher burden of invasive MRSA than the general US population. Further research is needed to evaluate trends over time and identify prevention strategies and opportunities for intervention. Disclosures All authors: No reported disclosures.

scholarly journals Young Women Had More Strokes Than Young Men in a Large, United States Claims Sample

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3352-3355 ◽  
Author(s):  
Michelle H. Leppert ◽  
P. Michael Ho ◽  
James Burke ◽  
Tracy E. Madsen ◽  
Dawn Kleindorfer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Incidence Rate ◽  
Young Women ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Stroke Rate ◽  
Index Stroke ◽  
Time Varying Covariates

Background and Purpose: Cardiovascular risk factors, which are overall more prevalent in men, are considered the major risk factors for strokes among young adults. However, recent European data found the incidence of strokes to be higher in young women. Using a large US claims sample, we examined sex differences in the index stroke rate of young adults. Methods: We performed a retrospective cohort study of enrollees in a 10% random sample of PharMetrics, a nationally representative claims database of insured Americans from 2001 to 2014. Outcomes were index ischemic stroke events, based on inpatient admissions using International Classification of Diseases-Ninth Revision codes. The index stroke rate was estimated from Poisson rate models with time varying covariates for 2-year periods, stratified by sex and age groups. Results: We identified 20 554 index strokes (50.4% women; mean age 63) including 5198 in young adults ages 15 to 54. There was no difference by sex in the index stroke rate in the extremes of age groups 15 to 24 and ≥75 years old. However, in the 25 to 34 and 35 to 44 year age groups, more women had strokes than men (incidence rate ratio: men:women, 0.70 [95% CI, 0.57–0.86]; 0.87 [95% CI, 0.78–0.98], respectively). In contrast, in the 45 to 54, 55 to 64, and 65 to 74 year age groups, more men had strokes (incidence rate ratio, 1.25 [95% CI, 1.16–1.33]; 1.41 [95% CI, 1.18–1.34]; 1.18 [95% CI, 1.12–125], respectively). Conclusions: More young women than men have strokes, suggesting possible importance of sex-mediated etiologies of stroke. Understanding these drivers is critical to stroke treatment and prevention efforts in young adults.

Abstract 14715: Diabetes and Relative Rates of Cardiovascular Events in Women Compared With Men

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Denis Angoulvant ◽  
Pierre Henri Ducluzeau ◽  
Peggy Renoult Pierre ◽  
Gregoire Fauchier ◽  
Julien Herbert ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sex Differences ◽  
Ischemic Stroke ◽  
Incidence Rate ◽  
Cardiovascular Events ◽  
Cardiovascular Complications ◽  
Incidence Rates ◽  
Adverse Cardiovascular Event ◽  
Men And Women ◽  
Diabetes Status

Data are inconsistent regarding sex-differences in the relative rates of cardiovascular events associated with diabetes. We aimed to investigate whether diabetes confers higher relative rates of cardiovascular events in women compared with men using contemporary data, and whether these sex-differences depend on age. Methods: All patients seen in French hospitals in 2013 with at least 5 years or follow-up (or dying earlier) without a history major adverse cardiovascular event, were identified and characterized by individual-level linkage of French nationwide administrative registers. They were categorized by diabetes-status and followed-up until 31 December 2019. Using Cox models, we calculated overall and age-dependent incidence rates, incidence rate ratios, and women-to-men ratios for myocardial infarction, heart failure, ischemic stroke, or cardiovascular death (MACE-HF). Results: The study included 3,381,472 individuals among whom 482,848 (14.3%) had diabetes (88.1% with type 2 diabetes). Among 482,848 (45% women) patients with diabetes, the absolute rate of MACE-HF was higher in men than in women (9.7 vs. 7.4 per 100 person-years). Corresponding absolute rates in men and women without diabetes were 4.9 vs. 3.1 per 100 person-years. Comparing individuals with and without diabetes, women had higher incidence rate ratio (IRR) of MACE-HF than men (IRR 2.42 95% confidence interval [CI] 2.40-2.44) in women vs. 1.99, 95% CI 1.98-2.01 in men) with a women-to-men ratio (WMR) of 1.22 (CI 1.20-1.23, p<0.001). The IRRs of MACE-HF for diabetes vs no diabetes were highest in women aged 45 and in the youngest men and decreased with advancing age for both men and women, but the IRRs were higher in women across all ages, with the highest WMR between age 45 and 70 years. This effect was more apparent for myocardial infarction (women-to-men ratio 1.43, 95%CI 1.39-1.47 after adjustment) than for ischemic stroke (WMR 1.10, 95%CI 1.07-1.13 after adjustment) or overall MACE-HF (WMR 1.16, 95%CI 1.15-1.18 after adjustment). Conclusion: Although men have higher absolute rates of cardiovascular complications, the relative rates of cardiovascular complications associated with diabetes are higher in women than in men across all ages in recent years.

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