Key result
AMI incidence rises ~200% over an 11-year period despite a recent post-peak decline.
Why the study?
Acute myocardial infarction remains a major global health problem with limited epidemiological data on temporal trends, clinical characteristics, and risk factors in transitional healthcare systems like Kosovo.
Cohort (n=13,099)
No
Absolute Event Rate: 71.3% vs 23.5%
p-value: p=<0.001
Over an 11-year period in Kosovo, AMI incidence initially rose and then declined, accompanied by a significant reduction in in-hospital mortality driven by increased use of primary percutaneous coronary intervention.
Fluctuating AMI incidence with falling mortality in Kosovo may reflect care gains; extends observational support for reperfusion uptake but leaves causality and generalizability open.
Background and Aim: Acute myocardial infarction (AMI) remains a major global health problem, being the leading cause of both morbidity and mortality. We aim to present the temporal trends, demographic, clinical characteristics and risk factors of AMI in Kosovo. Methodology: We conducted a retrospective, single-center observational study at the Clinic of Cardiology, University Clinical Center of Kosovo, having analyzed all patients admitted with AMI between January 2014 and December 2024. STEMI and NSTEMI cases were diagnosed according to ESC criteria. Patient's risk factors, biomarkers, PCI, and outcome data were extracted from hospital clinical records. Latent class analysis identified patient subgroups based on risk profiles. Temporal trends and projections of AMI incidence (per 100,000 population) were analyzed using polynomial and Joinpoint regression models. Statistical comparisons employed Chi-squared, t-tests, or Mann-Whitney U tests. Results: Over the course of 11 years, 13,099 AMI patients (mean age 63.8 years; 29% female) were admitted; 55% had STEMI and 45% NSTEMI. Annual Age-standardized incidence increased from 23.5 to 86.4 per 100,000 (2014-2021) then fell to 71.3 in 2024. Hypertension (66%), smoking (47%), diabetes (34%) and dyslipidemia were highly prevalent. Latent class analysis identified four distinct patient clusters with varying combinations of smoking, diabetes, hypertension and family history of cardiovascular disease (CVD) (p < 0.001). STEMI patients were younger, more often male and smokers, while NSTEMI patients were older with higher rates of diabetes, hypertension and prior LBBB. In-hospital mortality was 9.15%, higher for STEMI (~12%) than NSTEMI (~6%), and declined markedly over time (19.3% in 2014 vs 7-10% in 2022, p < 0.001). Conclusions: In a developing country, Kosovo, STEMI was more frequent than NSTEMI, affecting younger male patients. The leading risk factors included arterial hypertension, smoking, diabetes mellitus, and a family history of CVD. The decline in acute MI related mortality over recent years, can be explained by the increasing use of myocardial reperfusion procedures. Furthermore, the rates of acute MI related complications are not different from neighboring countries.
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Kryeziu et al. (2026) conducted a cohort in Acute myocardial infarction (n=13,099). Time period (2014-2024) vs. 2014 baseline was evaluated on Incidence of AMI per 100,000 population (p=<0.001). Over an 11-year period in Kosovo, the incidence of acute myocardial infarction increased from 23.5 per 100,000 in 2014 to a peak of 89.6 in 2021, before declining to 71.3 in 2024.
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