Jortveit Jarle, Pripp Are Hugo, Langørgen Jørund, Halvorsen Sigrun
Sørlandet Hospital, Arendal, Box 416, Lundsiden, 4604 Kristiansand, Norway.
Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Eur Heart J Open. 2022 Aug 10;2(5):oeac052. doi: 10.1093/ehjopen/oeac052. eCollection 2022 Sep.
Acute myocardial infarction (AMI) is a common cause of morbidity and mortality. The aim of the present study was to assess time trends in the incidence, treatment, and outcome of AMI in a nationwide registry-based cohort of patients.
All patients with a first AMI registered in the Norwegian Myocardial Infarction Registry between 2013 and 2019 were included in this cohort study. The number of patients admitted to Norwegian hospitals with a first AMI decreased from 8933 in 2013 to 8383 in 2019. The proportion of patients with ST-elevation myocardial infarction (STEMI) was stable at 30% throughout the period, and the percentage of STEMI undergoing coronary angiography was stable at 87%. The proportion of patients with non-STEMI undergoing coronary angiography increased by 2.4% per year (95% confidence interval 1.6-3.3) from 58% in 2013 to 68% in 2019. More patients were discharged with secondary preventive medication at the end of study period. Age-adjusted 1-year mortality was reduced from 16.4% in 2013 to 15.1% in 2018. The changes over time were primarily seen in the oldest patient groups.
In the period 2013-19 in Norway, we found a reduction in hospitalizations due to a first AMI. Both the percentage of patients undergoing coronary angiography as well as the percentage discharged with recommended secondary preventive therapy increased during the period, and the age-adjusted 1-year mortality after AMI decreased. A national AMI register provides important information about trends in incidence, treatment, and outcome, and may improve adherence to guideline recommendations.
急性心肌梗死（AMI）是发病和死亡的常见原因。本研究的目的是评估全国基于登记处的患者队列中AMI的发病率、治疗情况和结局的时间趋势。
本队列研究纳入了2013年至2019年在挪威心肌梗死登记处登记的所有首次发生AMI的患者。挪威医院收治的首次发生AMI的患者数量从2013年的8933例降至2019年的8383例。ST段抬高型心肌梗死（STEMI）患者的比例在整个期间稳定在30%，接受冠状动脉造影的STEMI患者百分比稳定在87%。非STEMI患者接受冠状动脉造影的比例从2013年的58%每年增加2.4%（95%置信区间1.6 - 3.3），至2019年达到68%。在研究期末，更多患者出院时使用了二级预防药物。年龄调整后的1年死亡率从2013年的16.4%降至2018年的15.1%。随时间的变化主要见于最年长的患者群体。
在2013 - 2019年期间的挪威，我们发现首次AMI导致的住院人数减少。在此期间，接受冠状动脉造影的患者百分比以及接受推荐二级预防治疗出院的患者百分比均有所增加，且AMI后年龄调整后的1年死亡率降低。国家AMI登记处提供了有关发病率、治疗和结局趋势的重要信息，并可能提高对指南建议的依从性。
