Difference in the incidence of hospitalizations for ST-segment elevation acute myocardial infarction in the last 20 years.

The electrocardiographic criteria for ST-segment elevation acute coronary syndrome (STEACS) have not changed over time and the electrocardiogram remains the main diagnostic tool of this clinical disorder. Thus, STEACS may be one of the most accurate clinical pictures for estimating differences in cardiovascular disease rates between different geographical locations or between different time periods in the same location. Recent studies suggest that hospitalizations for acute coronary syndrome have decreased in recent years due a reduction in hospitalizations for STEACS. The aim of the study was to identify differences in the incidence of hospitalizations for STEACS in our hospital over the past 20 years. We determined the incidence of hospitalizations for STEACS in our hospital during the periods 1991-1993 and 2009-2010. The diagnostic criteria for STEACS used in both periods were persistent ST-segment elevation, increases and decreases in markers of myocardial damage, and chest pain or discomfort. We only considered patients who were discharged to the cardiology unit from the intensive care unit (ICU) or directly admitted to the cardiology unit from the emergency department. This was because the information was obtained from the discharge reports for 2009-2010 and from the cardiology database for 19911993 and does not include patients who died in the ICU. In the period 1991-1993, 339 patients were admitted with STEACS. During this period our hospital had a catchment of 234 000 individuals, representing an annual rate of 48.2/100 000 population. In 2009-2010, 152 patients were admitted with STEACS from a catchment area of 256 000 inhabitants, representing a rate of 29.6/100 000 population. The figure shows the number of hospitalizations. The patients admitted in 2009-2010 were older, with a statistically significant difference between women. There were no differences in relation to sex, there were fewer anterior infarctions in the most recent period, and hospital stay has been reduced by approximately 1.5 days. The Table shows the