Coronary Artery Disease
Current Trend of Acute Myocardial Infarction in Korea (from the Korea Acute Myocardial Infarction Registry from 2006 to 2013)

https://doi.org/10.1016/j.amjcard.2014.09.019Get rights and content

Although the incidence of acute myocardial infarction (AMI) in Korea has been rapidly changed because of westernization of diet, lifestyle, and aging of the population, the recent trend of the myocardial infarction have not been reported by classification. We investigated recent trends in the incidence and mortality associated with the 2 major types of AMI. We reviewed 39,978 patients registered in the Korea Acute Myocardial Infarction Registry for either ST-segment elevation acute myocardial infarction (STEMI) or non–ST-segment elevation acute myocardial infarction (NSTEMI) from 2006 to 2013. When the rate for AMI were investigated according to each year, the incidence rates of STEMI decreased markedly from 60.5% in 2006 to 48.1% in 2013 (p <0.001). In contrast, a gradual increase in the incidence rates of NSTEMI was observed from 39.5% in 2006 to 51.9% in 2013 (p <0.001). As risk factors, hypertension, diabetes mellitus, and dyslipidemia were much more common in patients with NSTEMI than STEMI. Among medical treatments, the use of β blockers, angiotensin receptor blocker, and statin were increased from 2006 to 2013 in patients with STEMI and NSTEMI. Patients with STEMI and NSTEMI were more inclined to be increasingly treated by invasive treatments with percutaneous coronary intervention. In conclusion, this study demonstrated that the trend of myocardial infarction has been changed rapidly in the aspect of risk factors, ratio of STEMI versus NSTEMI, and therapeutic strategies during the recent 8 years in Korea.

Section snippets

Methods

KAMIR is the first nationwide, registry-observed, prospective, multicenter, online data collection study designed to reflect the “real world” clinical field in Korean patients presenting with AMI1, 2 and also to investigate the risk factors, incidence, and mortality of patients with AMI with the support of the Korean Circulation Society from November 2005. We enrolled patients who were diagnosed with AMI, including both patients with STEMI and NSTEMI. The diagnosis of AMI was based on a typical

Results

A total of 39,978 patients were hospitalized with confirmed AMI during the 8 years. The subjects with STEMI accounted for 56.3% (22,514), and those with NSTEMI accounted for 43.7% (17,464) of all patients. However, when the trend for AMI was investigated according to the year, the proportion of 2 types of AMI was significantly reversed. Interestingly, the incidence rates of STEMI decreased markedly from 60.5% in 2006 to 48.1% in 2013 (Figure 1). On the contrary, the incidence of NSTEMI was

Discussion

In many western countries, national health programs have been developed for the prevention and managing of AMI with cognition of importance and impact of that.9, 10, 11, 12 Also, giving consideration to the changed incidence of the 2 types of AMI, western countries tried to develop effective new strategy for AMI. Similarly, AMI has been becoming one of the leading causes of death in Korea because of prolonged life expectancy, rapid socioeconomic advances, change of lifestyle, and westernized

Disclosures

The authors have no conflicts of interest to disclose.

References (27)

Cited by (29)

  • Contemporary invasive management and in-hospital outcomes of patients with non–ST-segment elevation myocardial infarction in China: Findings from China Acute Myocardial Infarction (CAMI) Registry

    2019, American Heart Journal
    Citation Excerpt :

    There seemed to be interesting differences in risk factors between China and other countries (Table VI). Diabetes prevalence in our NSTEMI cohort was lower than that of the United States and other Asian countries like 33.8% in Korea Acute Myocardial Infarction Registry (KAMIR).15 In fact, the general prevalence of diabetes in China, although sharply increased (from 1% in 1980 to 10.9% in 2013), was still lower than those in Asian developed countries like Japan (12.1%), South Korean (13.7%), and Singapore (about 20%) at the same period.16

  • Impact of renin-angiotensin system inhibitors on long-term clinical outcomes in patients with acute myocardial infarction treated with successful percutaneous coronary intervention with drug-eluting stents: Comparison between STEMI and NSTEMI

    2019, Atherosclerosis
    Citation Excerpt :

    In case of NSTEMI, more early invasive strategy and secondary prevention treatments including antiplatelet agents, beta-blockers, and lipid lowering agents can reduce the incidence of adverse clinical outcomes [22–25]. Until recently, AMI has been increasing and represents one of the main causes of death in Korea associated with prolonged life expectancy, improved socioeconomic status, and westernized diet [26,27]. However, the mortality of coronary heart disease has decreased in advanced countries due to the tight control of cardiovascular risk factors, advancement of effective drugs, improvement of operative skills and equipment during PCI or CABG [28,29].

  • Patterns of Acute Myocardial Infarction in Taiwan from 2009 to 2015

    2018, American Journal of Cardiology
    Citation Excerpt :

    In Taiwan, there was a decrease in STEMI, yet NSTEMI incidence increased. Similar patterns were also reported from other countries.5,14–16 The increased use of a more sensitive troponin assay is a common explanation for the increased diagnosis of NSTEMI.

  • Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry

    2017, Journal of Cardiology
    Citation Excerpt :

    Thus, the final study cohort consisted of 8040 patients (Fig. 1). The incidence rates of STEMI in Korea were decreased compared to NSTEMI as in a previous report [11]. The mean age was 63.9 years with 74% of male patients.

  • Impact of Carvedilol Versus β<inf>1</inf>-Selective β Blockers (Bisoprolol, Metoprolol, and Nebivolol) in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

    2015, American Journal of Cardiology
    Citation Excerpt :

    However, the low event rate can be attributed to exclusion of inhospital deaths and high rates of use of guideline-adherent optimal therapies. Several studies have demonstrated improvements in survival after the first AMI, owing to the better acute inhospital treatment and secondary prevention.16,17 Third, the follow-up duration may have been too short to conclusively determine the long-term efficacy of different BBs in the setting of AMI.

View all citing articles on Scopus

This study was supported by grants of the Korean Society of Cardiology (2005-01), the Korea Centers for Disease Control & Prevention (2013-E63005-01), and the Korean Health Technology R&D Project, Ministry of Health and Welfare (HI13C1527), Republic of Korea.

See page 1821 for disclosure information.

View full text