Key result
Heart failure is linked to ~3.7-fold higher odds of recurrent acute myocardial infarction.
Why the study?
National data describing trends in hospitalized AMI incidence and recurrent AMI in Indonesia, particularly during the COVID-19 pandemic, were limited.
Observational (n=7,618)
Yes
Odds Ratio: 3.72 (95% CI 2.84–4.88)
p-value: p=<0.001
Hospitalized AMI incidence in Indonesia has surged past pre-pandemic levels, with recurrent AMI strongly clustered around modifiable cardiometabolic risk factors like heart failure, hypertension, and diabetes.
Post-pandemic AMI rebound with HF-linked recurrence may indicate secondary prevention gaps; leaves open whether targeted interventions reduce events in similar settings.
Background: Acute Myocardial Infarction (AMI) and recurrent AMI remain major contributors to cardiovascular morbidity and mortality in Indonesia. However, national data describing trends in hospitalized AMI incidence and recurrent AMI, particularly during the Coronavirus Disease 2019 (COVID-19) pandemic, are limited. Methods: We conducted a population-based analysis using nationally representative Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan, Social Health Insurance Administration Body) claims sample data from 2019 to 2024, excluding 2021 due to incomplete data. Hospitalized AMI incidence and temporal trends were evaluated using a repeated cross-sectional design, whereas recurrent AMI was examined using longitudinal patient-level linkage. AMI episodes were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes (I21–I22). Survey-weighted analyses estimated the incidence of hospitalized AMI, and survey-weighted logistic regression examined factors associated with recurrent AMI. Results: We identified 9,494 AMI episodes among 7,618 unique patients. Hospitalized AMI incidence per 100,000 insured population declined from 58.1 in 2019 to 49.8 in 2020, followed by a sustained increase, reaching 80.5 in 2024 and exceeding pre-pandemic levels. Overall, 13.5% of patients experienced recurrent AMI. Recurrent AMI was independently associated with heart failure (OR 3.72; 95% CI 2.84–4.88), hypertension (OR 3.00; 95% CI 2.27–3.96), diabetes mellitus (OR 1.61; 95% CI 1.19–2.17), and male sex (OR 1.57; 95% CI 1.20–2.05). Older age (≥65 years) was not independently associated with recurrent AMI. Conclusions: Hospitalized AMI incidence in Indonesia rebounded from the early COVID-19 decline and reached its highest level observed in 2024. Recurrent AMI clustered around modifiable cardiometabolic conditions, highlighting critical gaps in secondary prevention. Within a universal health coverage system, recurrent AMI may be a measurable, potentially preventable population-level outcome.
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Yolanda et al. (2026) conducted an observational in Acute Myocardial Infarction (n=7,618). Heart failure vs. Absence of heart failure was evaluated on Recurrent AMI (OR 3.72, 95% CI 2.84-4.88, p=<0.001). Hospitalized acute myocardial infarction incidence in Indonesia rebounded from an early COVID-19 decline to reach 80.5 per 100,000 in 2024, with recurrent AMI strongly associated with heart failure (OR 3.72).
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