Over a 25-year period, age-standardized AMI hospitalizations declined overall (AAPC -2.30%), with a shift from STEMI to NSTEMI predominance and decreased 30-day mortality for both phenotypes.
Observational (n=167,277)
Yes
Over a 25-year period, AMI presentations shifted from STEMI to NSTEMI predominance, accompanied by increased use of invasive care and decreased 30-day mortality, although sex disparities in PCI access persisted.
Effect estimate: AAPC -2.30%
BACKGROUND We examined 25-year population-level trends in acute myocardial infarction (AMI) in the Veneto Region (Northeastern Italy), assessing changes in incidence, patient characteristics, management strategies, and outcomes to evaluate the performance and evolution of the regional healthcare system. METHODS We conducted a retrospective population-based analysis of Veneto hospital discharge records (2000-2024), classifying AMI as ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) using ICD-9-CM codes. Key outcomes included same-day percutaneous coronary intervention (PCI), cardiac intensive care unit (CICU) and cardiology unit admission, and 30-day case-fatality, with analyses stratified by age and sex. Age-adjusted temporal trends were assessed using Joinpoint regression and reported as average annual percentage change (AAPC) with 95% confidence intervals. RESULTS During the study period, 167,277 patients were hospitalized for AMI: 57.3% STEMI and 42.7% NSTEMI. Age-standardized AMI hospitalizations declined overall AAPC -2.30%, driven by marked reductions in STEMI AAPC -4.72%, whereas NSTEMI increased AAPC +1.05% and became the predominant phenotype after 2016. Thirty-day mortality decreased for both STEMI AAPC -1.60% and NSTEMI AAPC -1.63%, with age-adjusted sex gaps substantially narrowing. Same-day PCI increased markedly over time AAPC +6.41%, as did CICU admission STEMI AAPC +0.85%; NSTEMI AAPC +0.27%, although women consistently underwent PCI less often. CONCLUSIONS Over 25 years, AMI in the Veneto Region shifted from STEMI to NSTEMI Predominance, with greater invasive care access and lower mortality, though sex disparities persisted, highlighting the need for targeted interventions.
Bilato et al. (2026) conducted an observational in Acute myocardial infarction (AMI) (n=167,277). Temporal trend analysis was evaluated on Age-standardized AMI hospitalizations (AAPC -2.30%). Over a 25-year period, age-standardized AMI hospitalizations declined overall (AAPC -2.30%), with a shift from STEMI to NSTEMI predominance and decreased 30-day mortality for both phenotypes.