Nationwide trends in the age adjusted prevalence of non-ST elevation myocardial infarction (NSTEMI) across various races and gender in the USA

BACKGROUND: Advances in the prevention and treatment of atherosclerosis have been dramatic. The goal of this study was to evaluate any decline in the age adjusted incidence of acute non ST elevation myocardial infarction (NSTEMI) using a large database. METHOD: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted rate for NSTEMI from 1988 to 2004 retrospectively. Specific ICD-9-CM codes for NSTEMI were used to compile the data. Patient demographic data was also analyzed from the database and adjusted for age. RESULTS: The NIS database contained a total of 1 423 156 patients who had a diagnosis of NSTEMI from 1988 to 2004. The age-adjusted rate for all acute NSTEMI gradually increased from 1988 until 2000-26.21 per 100 000 (95% CI: 23.9-28.4) in 1988 and 92.6 per 100 000 (95% CI: 86.0-99.3, P <0.01 in 2000,). It remained unchanged from 2000 until 2004 (91.7 per 100 000 (95% CI: 85.3-98.0). This trend was similar across different race and gender. CONCLUSION: The increasing incidence of NSTEMI from 1988 until year 2000 has suddenly stabilized by the year 2000. The cause of this finding is unknown. It could be related to the recent adaptation of troponin testing or recent advancement in the prevention and treatment of atherosclerosis.