Trends in acute coronary syndrome hospitalisation, incidence and mortality rates in young adults: an Australian linked data study.

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Samantha L Stiles, Ingrid Stacey, Judith M Katzenellenbogen, Tom Briffa, Karice Hyun, Frank M Sanfilippo, Derek P Chew, David Brieger, Lee Nedkoff
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引用次数: 0

Abstract

Background: Australian and international studies have reported an attenuation in previous declines in acute coronary syndrome (ACS) events in young adults. This study examines temporal trends in admission, mortality and incidence rates for ACS in men and women aged <55 years using multijurisdictional data for 2007-2016.

Methods: This population-based linked data study used hospital and mortality records from New South Wales, Western Australia and South Australia for 2002-2016. We identified all ACS hospitalisations and deaths, and first-ever (incident) events using a 5-year lookback period. Age-specific rates were calculated for ACS subgroups. Average annual percentage changes (95% CI) were estimated from age-adjusted Poisson regression models.

Results: There were 202 327 ACS events from 2007 to 2016, 27.6% (n=55 764) of which occurred in 20-54 years. ACS admission rates declined in all age and sex groupings, with greater declines in 55-74 years. Substantial declines in mortality rates of 6%-9%/year were seen across all sex and age groups. Reductions in total incidence were driven by declines in hospitalised ACS incidence. A decline in ST-segment elevation myocardial infarction (STEMI) incidence rates was observed, with the smallest reduction in younger women (-1.7%/year). Non-STEMI incidence rates increased by 1.9%/year (95% CI +0.8, +3.0) in women aged 20-54 years while remaining unchanged in young men.

Conclusions: While reductions in ACS incidence and mortality overall are encouraging, this study highlights increasing NSTEMI incidence and a smaller decline in STEMI incidence in young women compared with young adult men. A better understanding of sex-specific factors responsible for increasing rates is essential to continue to improve cardiovascular health.

年轻人急性冠状动脉综合征住院、发病率和死亡率的趋势:澳大利亚相关数据研究。
背景:澳大利亚和国际研究已经报道了年轻人急性冠脉综合征(ACS)事件的衰减。本研究考察了老年男性和女性ACS入院、死亡率和发病率的时间趋势。方法:这项基于人群的关联数据研究使用了2002-2016年新南威尔士州、西澳大利亚州和南澳大利亚州的医院和死亡率记录。我们确定了所有ACS住院和死亡,以及使用5年回顾期的首次(事件)事件。计算ACS亚组的年龄特异性发病率。平均年百分比变化(95% CI)由年龄校正泊松回归模型估计。结果:2007 - 2016年共发生202 327例ACS事件,其中27.6% (n=55 764)发生在20-54岁。ACS入院率在所有年龄和性别分组中均有所下降,其中55-74岁的下降幅度更大。所有性别和年龄组的死亡率均大幅下降,每年下降6%-9%。住院ACS发病率的下降推动了总发病率的降低。观察到st段抬高型心肌梗死(STEMI)发病率下降,年轻女性下降最小(-1.7%/年)。20-54岁女性的非stemi发病率增加1.9%/年(95% CI +0.8, +3.0),而年轻男性的发病率保持不变。结论:虽然ACS发病率和死亡率的总体下降令人鼓舞,但该研究强调,与年轻成年男性相比,年轻女性的非STEMI发病率增加,STEMI发病率下降幅度较小。更好地了解导致发病率上升的性别特异性因素对于继续改善心血管健康至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Epidemiology and Community Health
Journal of Epidemiology and Community Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.10
自引率
0.00%
发文量
100
审稿时长
3-6 weeks
期刊介绍: The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.
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