Recent Trends in the Incidence, Treatment, and Outcomes of Patients with STEMI and NSTEMI

Abstract

Background Despite the widespread use of electrocardiographic changes to characterize patients presenting with acute myocardial infarction, little is known about recent trends in the incidence rates, treatment, and outcomes of patients admitted for acute myocardial infarction further classified according to the presence of ST-segment elevation. The objectives of this population-based study were to examine recent trends in the incidence and death rates associated with the 2 major types of acute myocardial infarction in residents of a large central Massachusetts metropolitan area. Methods We reviewed the medical records of 5,383 residents of the Worcester (MA) metropolitan area hospitalized for either ST-segment elevation acute myocardial infarction (STEMI) or non-ST-segment acute myocardial infarction (NSTEMI) between 1997 and 2005 at 11 greater Worcester medical centers. Results The incidence rates (per 100,000) of STEMI declined appreciably (121 to 77), whereas the incidence rates of NSTEMI increased slightly (126 to 132), between 1997 and 2005. Although in-hospital and 30-day case-fatality rates remained stable in both groups, 1-year post discharge death rates declined between 1997 and 2005 for patients with STEMI and NSTEMI. Conclusions The results of this study demonstrate recent declines in the magnitude of STEMI, slight increases in the incidence rates of NSTEMI, and declines in long-term mortality in patients with STEMI and NSTEMI. Our findings suggest that acute myocardial infarction prevention and treatment efforts have resulted in favorable declines in the frequency of STEMI and death rates from the major types of acute myocardial infarction.