Cargando…
National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010
BACKGROUND: There are few data characterizing temporal changes in hospitalization for recurrent acute myocardial infarction (AMI) after AMI. METHODS AND RESULTS: Using a national sample of 2 305 441 Medicare beneficiaries hospitalized for AMI from 1999 to 2010, we evaluated changes in the incidence...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323804/ https://www.ncbi.nlm.nih.gov/pubmed/25249298 http://dx.doi.org/10.1161/JAHA.114.001197 |
_version_ | 1782356597941469184 |
---|---|
author | Chaudhry, Sarwat I. Khan, Rabeea F. Chen, Jersey Dharmarajan, Kumar Dodson, John A. Masoudi, Frederick A. Wang, Yun Krumholz, Harlan M. |
author_facet | Chaudhry, Sarwat I. Khan, Rabeea F. Chen, Jersey Dharmarajan, Kumar Dodson, John A. Masoudi, Frederick A. Wang, Yun Krumholz, Harlan M. |
author_sort | Chaudhry, Sarwat I. |
collection | PubMed |
description | BACKGROUND: There are few data characterizing temporal changes in hospitalization for recurrent acute myocardial infarction (AMI) after AMI. METHODS AND RESULTS: Using a national sample of 2 305 441 Medicare beneficiaries hospitalized for AMI from 1999 to 2010, we evaluated changes in the incidence of 1‐year recurrent AMI hospitalization and mortality using Cox proportional hazards models. The observed recurrent AMI hospitalization rate declined from 12.1% (95% CI 11.9 to 12.2) in 1999 to 8.9% (95% CI 8.8 to 9.1) in 2010, a relative decline of 26.4%. The observed recurrent AMI hospitalization rate declined by a relative 27.7% in whites, from 11.9% (95% CI 11.8 to 12.1) to 8.6% (95% CI 8.5 to 8.8) versus a relative decline in blacks of 13.6% from 13.2% (95% CI 12.6 to 13.8) to 11.4% (95% CI 10.9 to 12.0). The risk‐adjusted rate of annual decline in recurrent AMI hospitalizations was 4.1% (HR 0.959; 95% CI 0.958 to 0.961), and whites experienced a higher rate of decline (HR 0.957, 95% CI 0.956 to 0.959) than blacks (HR 0.974, 95% CI 0.970 to 0.979).The overall, observed 1‐year mortality rate after hospitalization for recurrent AMI declined from 32.4% in 1999 to 29.7% in 2010, a relative decline of 8.3% (P<0.05). In adjusted analyses, 1‐year mortality after recurrent AMI hospitalization declined 1.8% per year (HR, 0.982; 95% CI 0.980 to 0.985). CONCLUSIONS: In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period. |
format | Online Article Text |
id | pubmed-4323804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-43238042015-02-23 National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 Chaudhry, Sarwat I. Khan, Rabeea F. Chen, Jersey Dharmarajan, Kumar Dodson, John A. Masoudi, Frederick A. Wang, Yun Krumholz, Harlan M. J Am Heart Assoc Original Research BACKGROUND: There are few data characterizing temporal changes in hospitalization for recurrent acute myocardial infarction (AMI) after AMI. METHODS AND RESULTS: Using a national sample of 2 305 441 Medicare beneficiaries hospitalized for AMI from 1999 to 2010, we evaluated changes in the incidence of 1‐year recurrent AMI hospitalization and mortality using Cox proportional hazards models. The observed recurrent AMI hospitalization rate declined from 12.1% (95% CI 11.9 to 12.2) in 1999 to 8.9% (95% CI 8.8 to 9.1) in 2010, a relative decline of 26.4%. The observed recurrent AMI hospitalization rate declined by a relative 27.7% in whites, from 11.9% (95% CI 11.8 to 12.1) to 8.6% (95% CI 8.5 to 8.8) versus a relative decline in blacks of 13.6% from 13.2% (95% CI 12.6 to 13.8) to 11.4% (95% CI 10.9 to 12.0). The risk‐adjusted rate of annual decline in recurrent AMI hospitalizations was 4.1% (HR 0.959; 95% CI 0.958 to 0.961), and whites experienced a higher rate of decline (HR 0.957, 95% CI 0.956 to 0.959) than blacks (HR 0.974, 95% CI 0.970 to 0.979).The overall, observed 1‐year mortality rate after hospitalization for recurrent AMI declined from 32.4% in 1999 to 29.7% in 2010, a relative decline of 8.3% (P<0.05). In adjusted analyses, 1‐year mortality after recurrent AMI hospitalization declined 1.8% per year (HR, 0.982; 95% CI 0.980 to 0.985). CONCLUSIONS: In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period. Blackwell Publishing Ltd 2014-09-23 /pmc/articles/PMC4323804/ /pubmed/25249298 http://dx.doi.org/10.1161/JAHA.114.001197 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Chaudhry, Sarwat I. Khan, Rabeea F. Chen, Jersey Dharmarajan, Kumar Dodson, John A. Masoudi, Frederick A. Wang, Yun Krumholz, Harlan M. National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title | National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title_full | National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title_fullStr | National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title_full_unstemmed | National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title_short | National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010 |
title_sort | national trends in recurrent ami hospitalizations 1 year after acute myocardial infarction in medicare beneficiaries: 1999–2010 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323804/ https://www.ncbi.nlm.nih.gov/pubmed/25249298 http://dx.doi.org/10.1161/JAHA.114.001197 |
work_keys_str_mv | AT chaudhrysarwati nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT khanrabeeaf nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT chenjersey nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT dharmarajankumar nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT dodsonjohna nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT masoudifredericka nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT wangyun nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 AT krumholzharlanm nationaltrendsinrecurrentamihospitalizations1yearafteracutemyocardialinfarctioninmedicarebeneficiaries19992010 |