Trends in mortality and recurrent coronary heart disease events after an acute myocardial infarction among Medicare beneficiaries, 2001-2009.

Academic Article

Abstract

  • BACKGROUND: Few contemporary studies examine trends in recurrent coronary heart disease (CHD) events and mortality after acute myocardial infarction (AMI) and whether these trends vary by race or sex. METHODS: We used data from the national 5% random sample of Medicare fee-for-service beneficiaries for 1999 to 2010. We included beneficiaries who experienced an AMI (International Classification of Disease [ICD] 9 410.xx, except 410.x2) between January 1, 2001, and December 31, 2009. Each beneficiary's first AMI was included as their index event. Outcomes included all-cause mortality, recurrent AMI, and recurrent CHD events during the 365days after discharge for the index AMI. To examine secular trends, we pooled calendar years into 3 periods (2001-2003, 2004-2006, and 2007-2009). RESULTS: Among 48,688 beneficiaries with index AMIs from 2001 to 2009, we observed decreases in the age-adjusted rates for mortality (-3.8% for each 3-year period, 95% CI -6.1% to -1.6%, P trend = .001), recurrent AMI (-15.0%, 95% CI -18.6% to -11.2%, P trend < .001), and recurrent CHD events (-11.1%, 95% CI -14.0% to -8.0%, P trend < .001) in the 365days after the index AMI. In 2007 to 2009, blacks had excess risk relative to whites for mortality and recurrent AMI (black/white incidence rate ratio of 1.38 for mortality [95% CI 1.21-1.57] and 1.38 for recurrent AMI [95% CI 1.07-1.79]). CONCLUSIONS: Despite overall favorable trends in lower mortality and recurrent events after AMI, efforts are needed to reduce racial disparities.
  • Published In

    Keywords

  • Aged, Aged, 80 and over, Continental Population Groups, Coronary Disease, Female, Follow-Up Studies, Humans, Male, Medicare, Myocardial Infarction, Prognosis, Recurrence, Retrospective Studies, Risk Assessment, Risk Factors, Sex Distribution, Sex Factors, Survival Rate, United States
  • Digital Object Identifier (doi)

    Pubmed Id

  • 415753
  • Author List

  • Brown TM; Deng L; Becker DJ; Bittner V; Levitan EB; Rosenson RS; Safford MM; Muntner P
  • Start Page

  • 249
  • End Page

  • 255
  • Volume

  • 170
  • Issue

  • 2