Changes in characteristics, risk factors, and in-hospital mortality among patients with acute myocardial infarction in the capital of China over 40 years.

BACKGROUND: Acute myocardial infarction (AMI) has sharply increased and become a major cause of hospitalization and mortality in China over the past few decades, with the rapid economic development and substantial life-style changes.

METHODS: We compared the characteristics, risk factors, and in-hospital outcomes among 1314 patients with AMI from Beijing Collaborative Group data in 1972 and 1973, and 2200 patients in Beijing from China AMI registry in 2013 and 2014.

RESULTS: The proportions of patients with <30 and >70 years old in 2010s were significantly higher than those in 1970s (1970s vs 2010s: 0.2% vs 0.9% and 15.8% vs 25.6%, respectively, p < 0.05). The proportion of male patients was higher in 2010s (75.6%) than that (68.3%) in 1970s (p < 0.001). Rural population with AMI markedly increased (1970s vs 2010s: 6.5% vs 14.5%, p < 0.001). Patients with AMI in 2010s were more likely to have a history of diabetes mellitus (DM), prior stroke and myocardial infarction (MI) than those in 1970s (1970s vs 2010s: DM 6.2% vs 27.6%; prior stroke 6.2% vs 10.5%; prior MI 9.5% vs 11.9%; all p < 0.05). The in-hospital mortality was significantly lower in 2010s (2.6%) than that in 1970s (24%; p < 0.05).

CONCLUSIONS: Age, gender, rural population, diabetes, prior stroke and MI history as well as in-hospital mortality were significantly different among patients with AMI in Beijing over 40 years. The patterns most likely reflect big lifestyle changes, improved socioeconomic status, less targeted heart disease prevention programs, and advance in medical therapies.