ST elevation myocardial infarction epidemiology and demographics
ST elevation myocardial infarction Microchapters
Epidemiology and Demographics
ST elevation myocardial infarction epidemiology and demographics On the Web
Myocardial infarction is a common presentation of ischemic heart disease. The World Heart Organization (WHO) estimated in 2002 that, 12.6 percent of deaths worldwide were from ischemic heart disease.
Over 9 million patients in the United States alone have angina. An estimated 80,700,000 American adults (one in three) have one or more types of cardiovascular disease (CVD), of whom 38,200,000 are estimated to be age 60 or older. Except as noted, the estimates were extrapolated to the U.S. population in 2005 from NHANES 1999–2004. (Total CVD includes diseases in the bullet points below except for congenital heart disease). Due to overlap, it is not possible to add these conditions to arrive at a total.  
This means that roughly every 65 seconds, an American dies of a coronary event.
Although it is difficult to ascertain the true incidence of ST elevation myocardial infarction (STEMI), according to the ACC/AHA guidelines, a conservative estimate is that approximately 500,000 patients suffer STEMI each year . The incidence of STEMI has decreased over time. In an observational study of 5,832 metropolitan patients spanning from 1975 to 1997, the incidence of STEMI decreased from 171/100,000 to 101/100,000 
The following prevalence estimates are for people age 18 and older from NCHS/NHIS, 2005: 
- Among whites only, 12.0% have heart disease, 6.6% have CHD, 21.0% have hypertension and 2.3% have had a stroke.
- Among blacks, 10.2% have heart disease, 6.2% have CHD, 31.2% have hypertension and 3.4% have had a stroke.
- Among Hispanics or Latinos, 8.3% have heart disease, 5.9% have CHD, 20.3% have hypertension and 2.2% have had a stroke.
- Among Asians, 6.7% have heart disease, 3.8% have CHD, 19.4% have hypertension and 2.0% have had a stroke.
- Among Native Hawaiians or other Pacific Islanders, 22.4% have hypertension (other prevalence estimates considered unreliable).
The mortality among patients who suffer STEMI has progressively declined in recent years. From 1975 to 1997, one observational study reported that the in-hospital mortality decreased from 24% to 14% . In the Global Registry of Acute Coronary Events (GRACE), a multinational cohort study that includes 16,814 patients with STEMI were enrolled and followed up in 113 hospitals in 14 countries between 1999 and 2006, in-hospital mortality declined from 8.4% in 1999 to 4.6% in 2005 .
The reason for this decline in mortality is likely multifactorial and includes, but is certainly not limited to, decline in symptom onset-to-presentation time, more widespread use of primary PCI , improvements in time to reperfusion (door-to-needle and door-to-balloon times)  and improved medical therapy, including increases in the use of evidence-based therapies such as aspirin , beta blockers , clopidogrel , statins  and angiotension converting enzyme inhibitors or angiotensin receptor blockers .
- ↑ Cause of Death - UC Atlas of Global Inequality. Center for Global, International and Regional Studies (CGIRS) at the University of California Santa Cruz. Retrieved on December 7, 2006.
- ↑ 2008 Heart Disease and Stroke Statistics
- ↑ Anderson JL, Adams CD, Antman EM, et al (August 2007). "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction): developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". Circulation 116 (7): e148–304. doi:10.1161/CIRCULATIONAHA.107.181940. PMID 17679616.
- ↑ Anderson JL, Adams CD, Antman EM, et al (August 2007). "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". J. Am. Coll. Cardiol. 50 (7): e1–e157. doi:10.1016/j.jacc.2007.02.013. PMID 17692738.
- ↑ Antman EM, Anbe DT, Armstrong PW, et al (August 2004). "ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction)". J. Am. Coll. Cardiol. 44 (3): E1–E211. doi:10.1016/j.jacc.2004.07.014. PMID 15358047.
- ↑ 6.0 6.1 Furman MI, Dauerman HL, Goldberg RJ, Yarzebski J, Lessard D, Gore JM (May 2001). "Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial Q-wave and non-Q-wave myocardial infarction: a multi-hospital, community-wide perspective". J. Am. Coll. Cardiol. 37 (6): 1571–80. PMID 11345367.
- ↑ Vital Health Stat 10.2006 : 1–153
- ↑ Fox KA, Steg PG, Eagle KA, et al (May 2007). "Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006". JAMA 297 (17): 1892–900. doi:10.1001/jama.297.17.1892. PMID 17473299.
- ↑ Rogers WJ, Canto JG, Lambrew CT, et al (December 2000). "Temporal trends in the treatment of over 1.5 million patients with myocardial infarction in the US from 1990 through 1999: the National Registry of Myocardial Infarction 1, 2 and 3". J. Am. Coll. Cardiol. 36 (7): 2056–63. PMID 11127441.
- ↑ McNamara RL, Wang Y, Herrin J, et al (June 2006). "Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction". J. Am. Coll. Cardiol. 47 (11): 2180–6. doi:10.1016/j.jacc.2005.12.072. PMID 16750682.
- ↑ Nallamothu B, Fox KA, Kennelly BM, et al (December 2007). "Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events". Heart 93 (12): 1552–5. doi:10.1136/hrt.2006.112847. PMID 17591643.
- ↑ (August 1988) "Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group". Lancet 2 (8607): 349–60. PMID 2899772.
- ↑ (November 1985) "Metoprolol in acute myocardial infarction. Mortality. The MIAMI Trial Research Group". Am. J. Cardiol. 56 (14): 15G–22G. PMID 3904389.
- ↑ (July 1986) "Randomised trial of intravenous atenolol among 16 027 cases of suspected acute myocardial infarction: ISIS-1. First International Study of Infarct Survival Collaborative Group". Lancet 2 (8498): 57–66. PMID 2873379.
- ↑ Sabatine MS, Cannon CP, Gibson CM, et al (March 2005). "Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation". N. Engl. J. Med. 352 (12): 1179–89. doi:10.1056/NEJMoa050522. PMID 15758000.
- ↑ Cannon CP, Braunwald E, McCabe CH, et al (April 2004). "Intensive versus moderate lipid lowering with statins after acute coronary syndromes". N. Engl. J. Med. 350 (15): 1495–504. doi:10.1056/NEJMoa040583. PMID 15007110.
- ↑ Latini R, Maggioni AP, Flather M, Sleight P, Tognoni G (November 1995). "ACE inhibitor use in patients with myocardial infarction. Summary of evidence from clinical trials". Circulation 92 (10): 3132–7. PMID 7586285.
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