Urbanization, Life Style Changes and the Incidence/In-Hospital Mortality of Acute Myocardial Infarction in Japan
Key result
Rural residence was associated with a more rapid increase in the incidence of acute myocardial infarction (from 24.2 to 51.4 per 100,000 persons/year) compared to urban residence (31.3 to 40.8).
Why the study?
Are urbanization and lifestyle changes associated with the incidence and in-hospital mortality of acute myocardial infarction?
Population
19,921 patients with acute myocardial infarction registered in the MIYAGI-AMI Registry Study from 1988 to…
Comparison
Rural residence (outside Sendai City, n=11,402) vs Urban residence (inside Sendai City, n=7,316)
Design
Cohort
Follow-up
1988 to 2009 (registry period)
Authors
Discussion
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Member takes
Implication
Rural AMI incidence rising faster than urban; observational data leave urbanization's causal role open and should not yet change practice.
Study Design
Type
Observational (n=19,921)
Multicenter
Yes
Structured PICO
Are urbanization and lifestyle changes associated with the incidence and in-hospital mortality of acute myocardial infarction?
P
Population
19,921 patients with acute myocardial infarction registered in the prospective, multicenter MIYAGI-AMI Registry Study in Japan between 1988 and 2009.
E
Exposure
Rural residence (outside Sendai City, n=11,402)
C
Comparator
Urban residence (inside Sendai City, n=7,316)
O
Outcome
Incidence of AMI and in-hospital mortalityhard clinical
Main Result
Absolute Event Rate: 51.4% vs 40.8%
p-value: p=<0.001
AMI incidence has increased more rapidly in rural compared to urban areas in Japan over a 20-year period, alongside an increase in dyslipidemia, though in-hospital mortality has decreased overall.
Limitations
- Cannot completely confirm that all patients have been registered in the registry
- Diagnosis of AMI has been changing over 20 years (used CK instead of troponins)
- Observational study cannot establish cause-effect relationship
- Did not examine the prevalence of risk factors in control subjects or collect data on medical treatment for prevention
- Did not examine long-term mortality, only in-hospital mortality
Cite This Study
Hao et al. (2012) conducted an observational in Acute myocardial infarction (n=19,921). Rural residence vs. Urban residence was evaluated on Incidence of AMI (/100,000 persons/year) in 2009 (p=<0.001). Rural residence was associated with a more rapid increase in the incidence of acute myocardial infarction (from 24.2 to 51.4 per 100,000 persons/year) compared to urban residence (31.3 to 40.8).