Abstract 16115: The Incidence of Acute Coronary Syndrome in the Community: 2005 to 2010
Background: A temporal decline in the incidence of myocardial infarction (MI) has been reported; however temporal trends in the incidence of acute coronary syndrome (ACS) including MI and unstable angina (UA) are unknown.
Objective: To measure, in a community-based cohort, the incidence of ACS, defined as first ever MI or UA; and to evaluate any temporal decline in recent years.
Methods: Using a combination of ICD-9 codes 410-414, natural language processing of the medical records and biomarker measurements, Olmsted County, MN residents hospitalized between 1/1/2005-12/31/2010 were screened for incident ACS. ACS was defined as either MI validated by standard epidemiological criteria or UA validated by the Braunwald classification. The incidence rates were directly standardized to the age and sex distribution of the US 2000 population and the relative risk (RR) of ACS in 2010 compared to 2005 was calculated using Poisson regression.
Results: Among 1,090 incident ACS cases (mean±SD age 66.2±14.5, 60% male) identified, 31% were UA and 69% were MI. The standardized rates (per 100,000) of ACS were 247 (95% CI: 215-280) in 2005 and 162 (95% CI: 137-187) in 2010. The incidence of ACS was higher in men than women (figure). The rates for both declined over time but was more pronounced in women than men: RR (95% CI) of ACS in 2010 vs. 2005 for women: 0.52 (0.39-0.68) and for men: 0.70 (0.56-0.88). The magnitude of the temporal decline was similar for MI and UA (p=0.78).
Conclusions: In the community, UA constitutes approximately one third of all ACS. The incidence of ACS has declined in recent years and trends were similar for both MI and UA, thereby reaffirming a substantial decline in all acute manifestations of coronary disease.
- © 2012 by American Heart Association, Inc.