Different trends in the age-standardized incidence of ST-elevation and non-ST-elevation myocardial infarction in the province of Quebec, Canada between 2013 and 2021
Notice bibliographique
Résumé
Abstract Introduction Age-standardized incident trends in coronary heart disease (CHD) have shown a significant decline of 15% between 2013 and 2021 in the province of Quebec, Canada. The effect of the pandemic years has shown that ratios of the observed on expected age-standardized incident rates of CHD were slightly lower for 2020-2021, the first year of the pandemic whereas it was non-significant for 2021-2022, the second year of the pandemic. Purpose To describe how incident trends in acute myocardial infarction (AMI) and specifically between 2 subtypes: ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) have contributed to the decrease observed in CHD between 2013 and 2021, which includes 2 years of pandemic. Methods Using linked health administrative data for the whole population aged ≥20 years, starting in 1996 and updated annually, incident AMI were attributed if the International Classification of Disease tenth revision (ICD-10) code I21 was present in the hospital data, as a primary or in any secondary positions. STEMI and NSTEMI were defined with the presence of the ICD-10 code R94.30 and R94.31, respectively, in the hospital data in any secondary position. The 2011 Quebec standard population was used for age-standardization and 99% confidence intervals (CIs) were calculated using the gamma method. The temporal differences were considered to be significant if the CIs did not overlap. Results Crude incident rate of AMI was 3.17 per 1,000 in 2021. This included 0.64 per 1,000 for STEMI and 2.41 per 1,000 for NSTEMI, corresponding to 20,810 AMI, of which 4,280 were STEMI and 16,085 were NSTEMI (445 AMI were unclassified). The proportions of STEMI and NSTEMI between 2013 and 2021 were stable with a mean of 23% and 75%, respectively. Between 2013 and 2021, age-standardized incidence rates of AMI were stable with 2.78 per 1,000, [99% CI: 2.73-2.84] and 2.80 per 1,000, [2.75-2.85], respectively (Figure 1). However, different significant trends were observed: there was an 8% increase in incidence rates until 2018 (3.01 per 1,000, [2.96-3.06]) followed by a decrease, and then a notable increase in 2021. As illustrated in figure 1, a constant and significant decrease of 15% in the age-standardized incidence of STEMI was observed between 2013 (0.68 per 1,000, [0.66-0.71]) and 2021 (0.58 per 1,000, [0.56-0.60]) whereas NSTEMI increased globally of 11% between the same years (1.85 per 1,000, [1.81-1.90] and 2.06 per 1,000, [2.02-2.10]) and followed a similar trend as all AMI. Conclusion The decrease in the incidence of CHD could be attributed to the decrease in STEMI only since NSTEMI increased globally between 2013 and 2021 which explains the non-significant changes in the incident trends of all AMI. This suggests that public health efforts might have more effectively addressed factors leading to STEMI, as opposed to NSTEMI. The pandemic seems to have had varied impacts on different AMI subtypes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».