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      Long-Term Trend in the Incidence of Acute Myocardial Infarction in Korea: 1997-2007

      research-article
      , PhD 1 , , PhD 1 , , MS 2 , , MD 3 ,
      Korean Circulation Journal
      The Korean Society of Cardiology
      Myocardial infarction, Mortality, Prognosis

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          Abstract

          Background and Objectives

          Information about disease incidence is indispensable for the active prevention and control of acute myocardial infarction (AMI). The purpose of this study was to provide basic information for the establishment of policy related to AMI by examining the long-term trends in incidence of AMI.

          Subjects and Methods

          This study identified the trend in disease incidence during between 1997 and 2007 using the Korean National Health Insurance Database that includes AMI {the 10th International Classification of Disease (ICD-10) code: I21, I22, I23, I250, I251} as a primary or secondary disease.

          Results

          The attack and incidence rates for AMI in 2007 were 118.4 and 91.8 per 100,000 persons, respectively, and the rates more than doubled for the 11 years. Both rates were higher among males than females and increased more in the older age groups. Incidence cases accounted for most of the total attack cases every year; however, in recent years the proportion of relapse cases was on the rise. The case fatality rate was highest (14.5%) in 2000, and declined rapidly to 9.8% in 2007. The case fatality rate was higher among females than males and the older age groups; in particular, female patients ≥65 years of age had the highest fatality rate.

          Conclusion

          This study showed that AMI has been on the rise in Korea for 11 years. Therefore, the establishment of policy for intensive control of the incidence of AMI is necessary by building a continuous monitoring and surveillance system.

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          Most cited references29

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          Korean Statistical Information Service

          (2005)
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            Age at menopause and cause-specific mortality in South Korean women: Kangwha Cohort Study.

            The purpose of this study was to examine the relation between age at natural menopause and all-cause and cause-specific mortality among women. This study used the data of the Kangwha Cohort that was followed up from 1985 to 2001, in particular, for the group of 55 years or older women (n=2658). We calculated the hazard ratio of mortality by the group of age at menopause using the Cox proportional hazards model with adjustment for age, alcohol consumption, education, age at first birth, self-cognitive health level, chronic disease, marital partner, parity, age at menarche, oral contraceptive use and hypertension. The mean (standard deviation) age at menopause was 46.9 (4.9) years, and the median age was 48 years. After adjusting for the relevant variables, the risk of total death in the early menopause group (<40 years at menopause) was 1.32 times higher than that of the reference group (45-49 years at menopause) (95% confidence interval [CI], 1.05-1.66, p=0.02). For the early menopause group, relative to the reference group, the adjusted hazard ratios of death due to cardiovascular disease and cancer were 1.53 (95% CI, 1.00-2.39, p=0.04) and 2.01 (95% CI, 1.06-3.82, p=0.03), respectively. Through this study, the age at menopause was found to be different between Asian and Caucasian women and the association of age at menopause with death, particularly caused by cardiovascular disease and cancer, was validated. Our study is one of rare studies regarding the age at menopause of Asian women and their risk of mortality, which could be considered to be meaningful.
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              Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry.

              The objective of this study was to compare treatment and outcome of acute myocardial infarction in women and men. In this survey, patient hospital records were reviewed, and information about patient characteristics, treatments, and hospital events was entered in the Myocardial Infarction Triage and Intervention Registry. Between January 1988 and June 1990, a total of 4891 consecutive patients, including 1659 women, were hospitalized for acute myocardial infarction in 19 hospitals in the Seattle (Wash) metropolitan area. In-hospital thrombolytic therapy, coronary angiography, angioplasty, and bypass surgery were examined, as were in-hospital complications and death. Women were older and more often had histories previous hypertension and previous congestive heart failure. Thrombolytic therapy was used less often in women, although information about eligibility for treatment was not available to determine if this difference was due to treatment bias or differences in eligibility. Both coronary angiography and coronary angioplasty were used less frequently in women. However, of patients who had coronary angiography, equal proportions of women and men received angioplasty and/or coronary bypass surgery. Hospital mortality was 16% for women and 11% for men, although this difference was diminished by age adjustment. Mortality was higher in women undergoing bypass surgery, but this difference, too, was less apparent after age adjustment. Despite high levels of risk factors and mortality, coronary angiography and angioplasty were used less often in women, although among those who underwent coronary angiography, there were no gender differences in the use of angioplasty or bypass surgery. Clearly, more needs to be known about decision making for coronary angiography, as this process seems to differ for women and men with acute myocardial infarction.
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                Author and article information

                Journal
                Korean Circ J
                KCJ
                Korean Circulation Journal
                The Korean Society of Cardiology
                1738-5520
                1738-5555
                November 2009
                30 November 2009
                : 39
                : 11
                : 467-476
                Affiliations
                [1 ]Health Insurance Review & Assessment Policy Institute, Health Insurance Review & Assessment Service, Seoul, Korea.
                [2 ]Comprehensive Review System Planning Department, Health Insurance Review & Assessment Service, Seoul, Korea.
                [3 ]Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.
                Author notes
                Correspondence: Jaiyong Kim, MD, Department of Social and Preventive Medicine, Hallym University College of Medicine, 39 Hallimdaehak-gil, Chuncheon 220-702, Korea. Tel: 82-2-2182-2560, Fax: 82-2-2182-2650 dr_hongjs@ 123456hanmail.net
                Article
                10.4070/kcj.2009.39.11.467
                2790125
                19997542
                bad85be3-2a40-4854-ab4b-72ac198e8160
                Copyright © 2009 The Korean Society of Cardiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 January 2009
                : 24 February 2009
                : 13 March 2009
                Categories
                Original Article

                Cardiovascular Medicine
                myocardial infarction,prognosis,mortality
                Cardiovascular Medicine
                myocardial infarction, prognosis, mortality

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