Abstract 1035: Increasing Trend of the Incidence of Acute Myocardial Infarction Over 30 Years in Japan: Lessons From the MIYAGI-AMI Registry Study
Background: The number of elderly people is rapidly increasing worldwide and the rate of aging is the highest in Japan in the world, especially in female population. To explore the trend of acute myocardial infarction (AMI) in Japan, we have been conducting the Miyagi-AMI registry study for 30 years since 1979, where all AMI patients are prospectively registered in a Miyagi prefecture with a relatively stable population over those years.
Methods and Results: A total of 21,655 AMI patients (male/female 15,488/6,061) were registered in 1979 –2007 from the 43 hospitals. The age-adjusted incidence of AMI (per 100,000 persons per year) increased from 12.1 (male/female 21.3/6.6) in 1979 to 31.0 (male/female 53.7/11.4) in 2007 (Figure⇓), accompanied with male predominance and increased proportion of ≥80 years populations. Along with the increasing use of ambulance, the overall in-hospital mortality (age-adjusted) has been decreasing from ~20% in 1979. However, the in-hospital mortality still remains relatively high in female (11.8%), doubled of that of male (5.4%), in 2007. Indeed, in female patients, the accumulated number of risk factors was greater and the rate of primary percutaneous coronary intervention (PCI) was lower compared with male patients.
Conclusions: The MIYAGI-AMI registry study demonstrates the steady trend of the increasing incidence of AMI in a Japanese population, although the current rate is still lower than that in North America and Europe. In Japan, female population still remains at higher risk for in-hospital mortality of AMI, despite of the progress in medicine and primary PCI over the last 30 years.