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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...

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Autores principales: Chaudhry, Sarwat I., Khan, Rabeea F., Chen, Jersey, Dharmarajan, Kumar, Dodson, John A., Masoudi, Frederick A., Wang, Yun, Krumholz, Harlan M.
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
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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.
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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
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