ST elevation myocardial infarction epidemiology and demographics
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| Myocardial infarction Classification and external resources | |
 | |
|---|---|
| Diagram of a myocardial infarction (2) of the tip of the anterior wall of the heart (an apical infarct) after occlusion (1) of a branch of the left coronary artery (LCA, right coronary artery = RCA). | |
| ICD-10 | I21.-I22. |
| ICD-9 | 410 |
| DiseasesDB | 8664 |
| MedlinePlus | 000195 |
| eMedicine | med/1567 emerg/327 ped/2520 |
| Cardiology Network |
 Discuss ST elevation myocardial infarction epidemiology and demographics further in the WikiDoc Cardiology Network |
| Adult Congenital |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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Overview
Myocardial infarction is a common presentation of ischemic heart disease. The World Heart Organisation (WHO) estimated in 2002 that, 12.6 percent of deaths worldwide were from ischemic heart disease.
Ischemic heart disease is the leading cause of death in developed countries, but third to AIDS and lower respiratory infections in developing countries.[1]
In the United States, diseases of the heart are the leading cause of death, causing a higher mortality than cancer (malignant neoplasms).[1] Coronary heart disease is responsible for 1 in 5 deaths in the U.S.. Some 7,200,000 men and 6,000,000 women are living with some form of coronary heart disease. 1,200,000 people suffer a (new or recurrent) coronary attack every year, and about 40% of them die as a result of the attack.[1] 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 [1]. 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 [1]
Risk factors for STEMI mirror those for coronary artery disease (CAD) and include diabetes mellitus, cerebrovascular disease manifested by stroke or transient ischemic attack, peripheral arterial disease, aortic atherosclerosis and aneurysm, age (male ≥45 years old, female ≥55 years old), family history of premature CAD (MI or sudden death before age 55 in a first-degree male relative or before age 65 in a first-degree female relative), tobacco abuse, hypertension, hyperlipidemia and low high-density lipoprotein (HDL) [1]
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% [1]. 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 [1].
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 [1], improvements in time to reperfusion (door-to-needle and door-to-balloon times) [1] [1] and improved medical therapy, including increases in the use of evidence-based therapies such as aspirin [1], beta blockers [1] [1], clopidogrel [1], statins [1] and angiotension converting enzyme inhibitors or angiotensin receptor blockers [1]
See also
- acute coronary syndrome
- angina
- Cardiac arrest
- coronary thrombosis
- Hibernating myocardium
- Stunned myocardium
- Ventricular remodeling
References
External links
- Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study, from the United States National Heart, Lung and Blood Institute
- Heart Attack - overview of resources from MedlinePlus.
- Heart Attack Warning Signals from the Heart and Stroke Foundation of Canada
- Regional PCI for STEMI Resource Center - Evidence based online resource center for the development of regional PCI networks for acute STEMI
- STEMI Systems - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
- American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.
- American Heart Association's Heart Attack web site - Information and resources for preventing, recognizing and treating heart attack.
- The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research
- Clinical Trial Results: An up to dated resource of Cardiovascular Research
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .