Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle-aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

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Geographic Variations in In‐Hospital Mortality and Use of Percutaneous Coronary Intervention Following Acute Myocardial Infarction in China: A Nationwide Cross‐Sectional Analysis

Journal of the American Heart Association ◽

10.1161/jaha.117.008131 ◽

2018 ◽

Vol 7 (8) ◽

Cited By ~ 6

Author(s):

Hui Chen ◽

Lizheng Shi ◽

Ming Xue ◽

Ni Wang ◽

Xiao Dong ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Hospital Mortality ◽

Coronary Intervention ◽

Geographic Variations ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Percutaneous Coronary ◽

Sectional Analysis

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TEMPORAL TRENDS AND DIFFERENCES IN CLINICAL OUTCOMES AFTER ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH TYPE 1 VERSUS TYPE 2 DIABETES MELLITUS: A CROSS SECTIONAL ANALYSIS FROM THE NATIONAL INPATIENT SAMPLE 2000-2010

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31694-2 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1153

Author(s):

Parasuram Krishnamoorthy ◽

Akshaya Gopalakrishnan ◽

Sarah Amanullah ◽

Vincent Figueredo ◽

Aman Amanullah

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Acute Myocardial Infarction ◽

Temporal Trends ◽

National Inpatient Sample ◽

Cross Sectional ◽

Sectional Analysis

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Different Patterns in Ranking of Risk Factors for the Onset Age of Acute Myocardial Infarction between Urban and Rural Areas in Eastern Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115558 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5558

Author(s):

Hsiu-Ju Huang ◽

Chih-Wei Lee ◽

Tse-Hsi Li ◽

Tsung-Cheng Hsieh

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Onset Age ◽

Cross Sectional ◽

The Difference ◽

Urban And Rural Areas

This cross-sectional study aimed to investigate the difference in ranking of risk factors of onset age of acute myocardial infarction (AMI) between urban and rural areas in Eastern Taiwan. Data from 2013 initial onset of AMI patients living in the urban areas (n = 1060) and rural areas (n = 953) from January 2000 to December 2015, including onset age, and conventional risk factors including sex, smoking, diabetes, hypertension, dyslipidemia, and body mass index (BMI). The results of multiple linear regressions analysis showed smoking, obesity, and dyslipidemia were early-onset reversible risk factors of AMI in both areas. The ranking of impacts of them on the age from high to low was obesity (β = −6.7), smoking (β = −6.1), and dyslipidemia (β = −4.8) in the urban areas, while it was smoking (β = −8.5), obesity (β= −7.8), and dyslipidemia (β = −5.1) in the rural areas. Furthermore, the average onset ages for the patients who smoke, are obese, and have dyslipidemia simultaneously was significantly earlier than for patients with none of these comorbidities in both urban (13.6 years) and rural (14.9 years) areas. The findings of this study suggest that the different prevention strategies for AMI should be implemented in urban and rural areas.

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Use of intravenous magnesium sulfate among patients with acute myocardial infarction in China from 2001 to 2015: China PEACE—Retrospective AMI Study

BMJ Open ◽

10.1136/bmjopen-2019-033269 ◽

2020 ◽

Vol 10 (3) ◽

pp. e033269

Author(s):

Xianqiang Wang ◽

Xue Du ◽

Hao Yang ◽

Emily Bucholz ◽

Nicholas Downing ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Magnesium Sulfate ◽

Urban Areas ◽

Temporal Trends ◽

Sampling Strategy ◽

Reperfusion Therapy ◽

Intravenous Magnesium ◽

Nationally Representative ◽

Over Time

ObjectiveIn 2001, Chinese guidelines for the care of acute myocardial infarction (AMI) included a new recommendation against the routine use of magnesium. We studied temporal trends and institutional variation in the use of intravenous magnesium sulfate in nationally representative samples of individuals hospitalised with AMI in China between 2001 and 2015.MethodsIn an observational study (China PEACE—Retrospective Study) of AMI care, we used a two-stage, random sampling strategy to create a nationally representative sample of 28 208 patients with AMI at 162 Chinese hospitals in 2001, 2006, 2011 and 2015. The main outcome is use of intravenous magnesium sulfate over time.ResultsWe identified 24 418 patients admitted for AMI, without hypokalaemia, in the four study years. Over time, there was a significant initial decrease in intravenous magnesium sulfate use, from 32.1% in 2001 to 17.1% in 2015 (p<0.001 for trend). The decline was greater in the Eastern (from 33.3% to 16.5%) and Western (from 34.8% to 17.2%) regions, as compared with the Central region (from 25.9% to 18.1%), with little difference between rural and urban areas. The proportion of hospitals using intravenous magnesium sulfate did not change over time (from 81.3% to 77.9%). The median ORs, representing hospital-level variation, were 6.03 in 2001, 3.86 in 2006, 4.26 in 2011 and 4.72 in 2015. Intravenous magnesium sulfate use was associated with cardiac arrest at admission and receipt of reperfusion therapy, but no hospital-specific characteristics.ConclusionsDespite recommendations against its use, intravenous magnesium sulfate is used in about one in six patients with AMI in China. Our findings highlight the need for more efficient mechanisms to stop using ineffective therapies to improve patients’ outcomes and reduce medical waste.Trial registration numberClinicalTrials.gov (NCT01624883)

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