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Cohort study highlights continuing decline of MI
Kaiser Permanente Northern California reported a 23% decline in the rate of MI among its members from 2008 to 2014; the findings build on research published in 2010 which showed a 24% decline in the MI rate between 1999 and 2008.
Matthew D. Solomon, MD, PhD, of the division of cardiology, Kaiser Permanente Oakland Medical Center and adjunct investigator at the Kaiser Permanente Northern California Division of Research, and colleagues identified 29,087 patients aged 18 years or older who experienced acute MI (32,661 events). Of these, 22,684 patients had one or more non-STEMI (25,602 events) and 6,937 had at least one STEMI (7,059 events). Patients with STEMI were more likely to be younger (64 years vs. 68 years) and men (69% vs. 61%). During the study period, rates for overall acute MI (2008: 225 per 100,000 person-years; 2014: 173 per 100,000 person-years), non-STEMI (2008: 177 per 100,000 person-years; 2014: 136 per 100,000 person-years) and STEMI (2008: 47 per 100,000 person-years; 2014: 37 per 100,000 person-years) all declined (P < .01 for all).
Solomon and colleagues also reported that despite men having higher MI rates vs. women, older patients having higher rates vs. younger patients, and patients with diabetes having higher rates vs. those without diabetes, all groups saw a decrease in rates.
“Reductions were consistent across age, sex, and [diabetes] subgroups. However, although previous declines were driven primarily by fewer STEMIs, the driving force since 2008 was fewer non-STEMIs,” the researchers wrote.
Solomon said in an interview with Cardiology Today that the reason for the bigger decline in non-STEMI vs. STEMI could be because the reduction of STEMIs has been so dramatic that clinicians may have reached the limit of their ability to further reduce them.
According to Solomon, Kaiser’s MI rate reduction is slightly ahead of national rates, but across the country, MI rates are also declining.
“The biggest takeaway from the study is that we should be very proud of our efforts in primary and secondary prevention, but that there is always more work to be done,” he said. – by Tracey Romero
Disclosure: The study was sponsored by Genentech. Solomon reports receiving research funding from Abbott Vascular and Genentech. Please see the full study for a list of all other researchers’ financial disclosures.