Eleven-year trends of acute myocardial infarction incidence, mortality and case-fatality rate in Shanghai: a 1.09 million population based surveillance study

The objective of this study was to estimate trends in the incidence, mortality rate and 28-day case-fatality rate of acute myocardial infarction (AMI) between 2004 and 2014 based on 11community population in Shanghai. We appraised the risk factors for the shortand long-term mortality. Age-adjusted rates were computed. Chisquare test was used to test the rate differences between men and women. Annual percentage changes (APC) were obtained by Joinpoint regression. Logistic regression and Cox regression were used to analyze the risk factors of short-term and long-term mortality, respectively. A total of 5651 AMI events occurred. For the first 5 years, the rates increased significantly, and then kept stable or decreased sharply from 2008 to 2014. The elder patients had extremely higher rates. For the case-fatality, no transition point was observed. Female patients had a significant higher fatality rate, comparing with male patients. Old age, history of coronary heart disease and hyperlipidemia are the risk factors for shortand long-term mortality. The level of hospital and history of hypertension are the protective factors. Conclusively, successful measures of public health and clinical efforts reversed the increasing trends from 2008 to 2014. Further research on risk factors is required.