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

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.

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Intradialytic Hypotension and Cardiac Arrhythmias in Patients Undergoing Maintenance Hemodialysis

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.06810619 ◽

2020 ◽

Vol 15 (6) ◽

pp. 805-812 ◽

Cited By ~ 1

Author(s):

Finnian R. Mc Causland ◽

Jim A. Tumlin ◽

Prabir Roy-Chaudhury ◽

Bruce A. Koplan ◽

Alexandru I. Costea ◽

...

Keyword(s):

United States ◽

Confidence Interval ◽

Incidence Rate ◽

Rate Ratio ◽

Negative Binomial ◽

Incidence Rate Ratio ◽

The United States ◽

Maintenance Hemodialysis ◽

Intradialytic Hypotension ◽

Clinically Significant

Background and objectivesPatients receiving maintenance hemodialysis (HD) have a high incidence of cardiac events, including arrhythmia and sudden death. Intradialytic hypotension (IDH) is a common complication of HD and is associated with development of reduced myocardial perfusion, a potential risk factor for arrhythmia.Design, setting, participants, & measurementsWe analyzed data from the Monitoring in Dialysis study, which used implantable loop recorders to detect and continuously monitor electrocardiographic data from patients on maintenance HD (n=66 from the United States and India) over a 6-month period (n=4720 sessions). Negative binomial mixed effects regression was used to test the association of IDH20 (decline in systolic BP >20 mm Hg from predialysis systolic BP) and IDH0–20 (decline in systolic BP 0–20 mm Hg from predialysis systolic BP) with clinically significant arrhythmia (bradycardia≤40 bpm for ≥6 seconds, asystole≥3 seconds, ventricular tachycardia ≥130 bpm for ≥30 seconds, or patient-marked events) during HD.ResultsThe median age of participants was 58 (25th–75th percentile, 49–66) years; 70% were male; and 65% were from the United States. IDH occurred in 2251 (48%) of the 4720 HD sessions analyzed, whereas IDH0–20 occurred during 1773 sessions (38%). The number of sessions complicated by least one intradialytic clinically significant arrhythmia was 27 (1.2%) where IDH20 occurred and 15 (0.8%) where IDH0–20 occurred. Participants who experienced IDH20 (versus not) had a nine-fold greater rate of developing an intradialytic clinically significant arrhythmia (incidence rate ratio, 9.4; 95% confidence interval, 3.0 to 29.4), whereas IDH0–20 was associated with a seven-fold higher rate (incidence rate ratio, 7.2; 95% confidence interval, 2.1 to 25.4).ConclusionsIDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia.

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Anticoagulation for valvular heart disease in community-based practice

Thrombosis and Haemostasis ◽

10.1160/th09-07-0450 ◽

2010 ◽

Vol 103 (02) ◽

pp. 329-337 ◽

Cited By ~ 2

Author(s):

Al Ozonoff ◽

Lori Henault ◽

Elaine Hylek ◽

Adam Rose

Keyword(s):

United States ◽

Heart Disease ◽

Incidence Rate ◽

Valvular Heart Disease ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

The United States ◽

Major Haemorrhage ◽

Target Range ◽

Community Based

SummaryLittle is known about patients who receive oral anticoagulation for valvular heart disease (VHD) in community-based practice. It was this study’s objective to describe the characteristics, management, and outcomes of patients anticoagulated for VHD, compared to patients anticoagulated for atrial fibrillation (AF). We used a nationally-representative cohort of community-based anticoagulation care in the United States. Data collected included indications for therapy, demographics, selected comorbid conditions, international normalised ratio (INR) target ranges, INR control, and clinical outcomes. We identified 1,057 patients anticoagulated for VHD (15.6% of the overall cohort) and 3,396 patients anticoagulated for AF (50.2%). INR variability was similar between the two groups (0.64 vs. 0.69, p = 0.80). Among patients with aortic VHD, for whom a standard (2–3) target INR range is recommended, 461 (84%) had a high target range (2.5–3.5), while 95 (16%) had a standard target range. VHD patients had a higher rate of major haemorrhage compared to AF patients (3.57 vs. 1.78 events per 100 patient-years, incidence rate ratio 2.02, 95% CI 1.33 – 3.06). The rate of stroke/systemic embolus was similar between groups (0.67 vs. 0.97 events per 100 patient-years, incidence rate ratio 0.71, 95% CI 0.32 – 1.57). In our community-based study, approximately 15.6% of patients receiving warfarin were anticoagulated for VHD. VHD patients achieved similar anticoagulation control to patients with AF, as measured by INR variability. Nevertheless, the rate of major haemorrhage was elevated among VHD patients compared to AF patients; this finding requires further investigation.Disclaimer: The opinions expressed in this manuscript do not necessarily represent the views or policies of the United States Department of Veterans Affairs.

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Newly incident cannabis use in the United States, 2002–2011: a regional and state level benchmark

PeerJ ◽

10.7717/peerj.3616 ◽

2017 ◽

Vol 5 ◽

pp. e3616 ◽

Cited By ~ 1

Author(s):

Jacob P. Leinweber ◽

Hui G. Cheng ◽

Catalina Lopez-Quintero ◽

James C. Anthony

Keyword(s):

United States ◽

Incidence Rate ◽

Meta Analysis ◽

State Level ◽

The United States ◽

Incidence Rates ◽

Cannabis Use ◽

Border Region ◽

Community Residents ◽

Mexico Border

BackgroundCannabis use and cannabis regulatory policies recently re-surfaced as noteworthy global research and social media topics, including claims that Mexicans have been sending cannabis and other drug supplies through a porous border into the United States. These circumstances prompted us to conduct an epidemiological test of whether the states bordering Mexico had exceptionally large cannabis incidence rates for 2002–2011. The resulting range of cannabis incidence rates disclosed here can serve as 2002–2011 benchmark values against which estimates from later years can be compared.MethodsThe population under study is 12-to-24-year-old non-institutionalized civilian community residents of the US, sampled and assessed with confidential audio computer-assisted self-interviews (ACASI) during National Surveys on Drug Use and Health, 2002–2011 (aggregaten ∼ 420,000) for which public use datasets were available. We estimated state-specific cannabis incidence rates based on independent replication sample surveys across these years, and derived meta-analysis estimates for 10 pre-specified regions, including the Mexico border region.ResultsFrom meta-analysis, the estimated annual incidence rate for cannabis use in the Mexico Border Region is 5% (95% CI [4%–7%]), which is not an exceptional value relative to the overall US estimate of 6% (95% CI [5%–6%]). Geographically quite distant from Mexico and from states of the western US with liberalized cannabis policies, the North Atlantic Region population has the numerically largest incidence estimate at 7% (95% CI [6%–8%]), while the Gulf of Mexico Border Region population has the lowest incidence rate at 5% (95% CI [4%–6%]). Within the set of state-specific estimates, Vermont’s and Utah’s populations have the largest and smallest incidence rates, respectively (VT: 9%; 95% CI [8%–10%]; UT: 3%; 95% CI [3%–4%]).DiscussionBased on this study’s estimates, among 12-to-24-year-old US community residents, an estimated 6% start to use cannabis each year (roughly one in 16). Relatively minor variation in region-wise and state-level estimates is seen, although Vermont and Utah might be exceptional. As of 2011, proximity to Mexico, to Canada, and to the western states with liberalized policies apparently has induced little variation in cannabis incidence rates. Our primary intent was to create a set of benchmark estimates for state-specific and region-specific population incidence rates for cannabis use, using meta-analysis based on independent US survey replications. Public health officials and policy analysts now can use these benchmark estimates from 2002–2011 for planning, and in comparisons with newer estimates.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.624 ◽

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.

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Nonlinear Burkitt lymphoma risk patterns with age and CD4 lymphocyte count among persons with AIDS in the United States

Infectious Agents and Cancer ◽

10.1186/1750-9378-5-s1-a58 ◽

2010 ◽

Vol 5 (S1) ◽

Author(s):

Mercy Guech-Ongey ◽

Eric A Engels ◽

William F Anderson ◽

Kishor Bhatia ◽

Edgar P Simard ◽

...

Keyword(s):

United States ◽

Burkitt Lymphoma ◽

Lymphocyte Count ◽

The United States ◽

Cd4 Lymphocyte Count ◽

Cd4 Lymphocyte ◽

Lymphoma Risk

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The epidemiology of spinal schwannoma in the United States between 2006 and 2014

Journal of Neurosurgery Spine ◽

10.3171/2019.10.spine191025 ◽

2020 ◽

Vol 32 (5) ◽

pp. 661-666 ◽

Cited By ~ 1

Author(s):

Shahed Tish ◽

Ghaith Habboub ◽

Min Lang ◽

Quinn T. Ostrom ◽

Carol Kruchko ◽

...

Keyword(s):

United States ◽

Brain Tumor ◽

Incidence Rate ◽

Cancer Registries ◽

The United States ◽

Incidence Rates ◽

American Population ◽

Study Results ◽

Spinal Schwannoma ◽

Adjusted Incidence

OBJECTIVESpinal schwannoma remains the third most common intradural spinal tumor following spinal meningioma and ependymoma. The available literature is generally limited to single-institution reports rather than epidemiological investigations. As of 1/1/2004, registration of all benign central nervous system tumors in the United States became mandatory after the Benign Brain Tumor Cancer Registries Amendment Act took action, which provided massive resources for United States population-based epidemiological studies. This article describes the epidemiology of spinal schwannoma in the United States from January 1, 2006, through December 31, 2014.METHODSIn this study, the authors utilized the Central Brain Tumor Registry of the United States, which corresponds to 100% of the American population. The Centers for Disease Control and Prevention’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance Epidemiology and End Results program provide the resource for this data registry. The authors included diagnosis years 2006 to 2014. They used the codes per the International Coding of Diseases for Oncology, 3rd Edition: histology code 9560/0 and site codes C72.0 (spinal cord), C70.1 (spinal meninges), and C72.1 (cauda equina). Rates are per 100,000 persons and are age-adjusted to the 2000 United States standard population. The age-adjusted incidence rates and 95% confidence intervals are calculated by age, sex, race, and ethnicity.RESULTSThere were 6989 spinal schwannoma cases between the years 2006 and 2014. The yearly incidence eminently increased between 2010 and 2014. Total incidence rate was 0.24 (95% CI 0.23–0.24) per 100,000 persons. The peak adjusted incidence rate was seen in patients who ranged in age from 65 to 74 years. Spinal schwannomas were less common in females than they were in males (incidence rate ratio = 0.85; p < 0.001), and they were less common in blacks than they were in whites (IRR = 0.52; p < 0.001) and American Indians/Alaska Natives (IRR = 0.50; p < 0.001) compared to whites. There was no statistically significant difference in incidence rate between whites and Asian or Pacific Islanders (IRR = 0.92; p = 0.16).CONCLUSIONSThe authors’ study results demonstrated a steady increase in the incidence of spinal schwannomas between 2010 and 2014. Male sex and the age range 65–74 years were associated with higher incidence rates of spinal schwannomas, whereas black and American Indian/Alaska Native races were associated with lower incidence rates. The present study represents the most thorough assessment of spinal schwannoma epidemiology in the American population.

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Pulmonary complications with the use of mTOR inhibitors in targeted cancer therapy: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.362 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 362-362

Author(s):

Benjamin Adam Gartrell ◽

Jian Ying ◽

Shanthi Sivendran ◽

Neeraj Agarwal ◽

Kenneth M. Boucher ◽

...

Keyword(s):

Adverse Events ◽

Incidence Rate ◽

Solid Tumors ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Meta Analysis ◽

Mtor Inhibitors ◽

Incidence Rates ◽

Pulmonary Complications ◽

Grade 3

362 Background: mTOR inhibitors are approved in several malignancies including renal cell carcinoma (RCC). While pulmonary toxicities are a recognized adverse effect associated with this drug class, the frequency and risk of these side effects have not been well characterized. Methods: Clinical trials of mTOR inhibitors in solid tumors were identified through a search of PubMed and ASCO abstracts. Prospective studies of temsirolimus, everolimus, and ridaforolimus in solid tumors were evaluated for inclusion. 22 eligible phase II and phase III trials that included 4,242 patients were identified and included in a systematic review and meta-analysis. Adverse event data was extracted for pulmonary complications including pneumonitis, dyspnea, and cough. The incidence rate and the incidence rate ratios were determined for these pulmonary adverse events. Results: Based on our analysis of the 20 trials that reported pneumonitis, the incidence rate of any grade pneumonitis in patients with solid tumors treated with mTOR inhibitors is 0.11 (95% CI, 0.06-0.17). The incidence rate of grade 3 or 4 pneumonitis is 0.03 (95% CI, 0.01-0.04). The incidence rate ratio of any grade pneumonitis with mTOR inhibitors relative to controls is 18.9 (95% CI, 6.5-55.1), and the incidence rate ratio for the development of grade 3 or 4 pneumonitis is 7.9 (95% CI, 2.6-24.0). The incidence rates of any grade cough and dyspnea were found to be 0.23 (95% CI, 0.20-0.27) and 0.15 (95% CI, 0.10-0.21), respectively. The incidence rates of grade 3 or 4 cough and dyspnea are found to be 0.01 (95% CI, 0.00-0.01) and 0.03 (95% CI, 0.02-0.04), respectively. There was a statistically significant, but modest increase in risk of developing any grade cough (incidence rate ratio of 1.9 [95% CI, 1.6-2.4]) and grade 3 or 4 dyspnea (incidence rate ratio of 2.0 [95% CI, 1.2-3.3]) with mTOR inhibitors relative to controls. Conclusions: This study confirms that mTOR inhibitors are associated with pulmonary adverse events and provides a quantitative estimation of the risk of these adverse events in solid tumor patients treated with these drugs. The majority of pulmonary adverse events are low grade.

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1835. High Burden of Invasive Staphylococcus aureus Disease Among Native Americans on the White Mountain Apache Tribal Lands

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.097 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S44-S45

Author(s):

Catherine Sutcliffe ◽

Lindsay Grant ◽

Angelina Reid ◽

Grace K Douglass ◽

Laura B Brown ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Native American ◽

Native Americans ◽

Incidence Rate ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Incidence Rates ◽

Significant Difference ◽

White Mountain Apache ◽

Tribal Lands

Abstract Background Native Americans in the southwestern United States (US) have a higher risk of many infectious diseases than the general US population. The objective of this study was to determine the burden of invasive Staphylococcus aureus disease among Native Americans on the White Mountain Apache (WMA) Tribal lands. 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 WMA Tribal lands with S. aureus isolated from a normally sterile site. Incidence rates were calculated using the Indian Health Service User Population as the denominator. Age-standardized incidence rates were calculated by direct standardization methods using US Census data from 2015 as the reference. Results Fifty-three cases were identified (Year 1: 24; Year 2: 29). Most cases were adults (90.6%; median age: 47.4 years) and had ≥1 underlying medical condition (86.8%), of which the most common were obesity (50.0%) and diabetes (50.0%). 26.4% of cases were categorized as community acquired. Most infections were methicillin-resistant (MRSA; 75.5%). 88.7% of cases were hospitalized, 7.5% required amputation, and 7.7% died within 30 days of the initial culture. The overall incidence of invasive S. aureus was 156.3 per 100,000 persons (95% confidence interval [CI]: 119.4, 204.5) with no significant difference in the incidence by year (Year 1: 141.5; Year 2: 171.1; incidence rate ratio: 1.21; 95% CI: 0.70, 2.08). The overall incidence of invasive MRSA was 118.0 per 100,000 persons (95% CI: 86.5, 160.8) with no significant difference by year (Year 1: 106.1; Year 2: 129.8; incidence rate ratio: 1.22; 95% CI: 0.66, 2.28). The incidence of invasive S. aureus and MRSA increased with age and was highest among individuals 50–64 years of age. The overall age-adjusted incidence of invasive MRSA was 138.2 per 100,000 persons (Year 1: 125.2; Year 2: 150.9, for comparison US 2015 general population: 18.8 per 100,000 persons). Conclusion The WMA community has one of the highest reported incidence rates globally of invasive MRSA. Interventions are urgently needed in this community to reduce the morbidity and mortality associated with these infections. Disclosures All Authors: No reported Disclosures.

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Delay in the Effect of Restricting Community Mobility on the Spread of COVID-19 During the First Wave in the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab586 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Shan He ◽

Jooyoung Lee ◽

Benjamin Langworthy ◽

Junyi Xin ◽

Peter James ◽

...

Keyword(s):

United States ◽

Incidence Rate ◽

Human Mobility ◽

Disease Incidence ◽

Human Movement ◽

Credible Interval ◽

The United States ◽

Incidence Rates ◽

Grocery Stores ◽

Minimal Impact

Abstract Background It remains unclear how changes in human mobility shaped the transmission dynamic of coronavirus disease 2019 (COVID-19) during its first wave in the United States. Methods By coupling a Bayesian hierarchical spatiotemporal model with reported case data and Google mobility data at the county level, we found that changes in movement were associated with notable changes in reported COVID-19 incidence rates about 5 to 7 weeks later. Results Among all movement types, residential stay was the most influential driver of COVID-19 incidence rate, with a 10% increase 7 weeks ago reducing the disease incidence rate by 13% (95% credible interval, 6%–20%). A 10% increase in movement from home to workplaces, retail and recreation stores, public transit, grocery stores, and pharmacies 7 weeks ago was associated with an increase of 5%–8% in the COVID-10 incidence rate. In contrast, parks-related movement showed minimal impact. Conclusions Policy-makers should anticipate such a delay when planning intervention strategies restricting human movement.

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

European Journal of Preventive Cardiology ◽

10.1177/2047487318780033 ◽

2018 ◽

Vol 25 (10) ◽

pp. 1031-1039 ◽

Cited By ~ 15

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.

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