Continued decline in the incidence of myocardial infarction beyond the COVID-19 pandemic : a nationwide study of the Swedish population aged 60 and older during 2015-2022
Meyer, Anna C. (Karolinska Institutet (Suècia))
Ebeling, Marcus (Max Planck Institute for Demographic Research)
Acosta, Enrique (Centre d'Estudis Demogràfics)
Modig, Karin (Karolinska Institutet (Suècia))
Centre d'Estudis Demogràfics

Date:	2024
Abstract:	The number of myocardial infarctions declined during the early COVID-19 pandemic but mechanisms behind these declines are poorly understood. COVID-19 infection is also associated with an increased risk of myocardial infarction which could lead to higher incidence rates in the population. This study aims to shed light on the seemingly paradoxical relationship between COVID-19 and myocardial infarction occurrence on the population level by exploring long-term trends in incidence rates, case fatality, and proportion of patients dying before reaching a hospital. Our work is based on a linkage of administrative registers covering the entire population aged 60 + in Sweden. Considering both long-term trends since 2015 and seasonal variability, we compared observed incidence, case fatality, and proportions of patients hospitalized to expected values during 2020-2022. Despite more than 200 laboratory-confirmed COVID-19 cases per 1000 inhabitants by the end of 2022, incidence rates of myocardial infarction continued to decline, thus following the long-term trend observed already before 2020. During the first pandemic wave there was an additional incidence decline corresponding to 13% fewer myocardial infarctions than expected. This decline was neither accompanied by increasing case fatality nor by lower shares of patients being hospitalized. We found no increase in the population-level incidence of myocardial infarction despite large-scale exposure to COVID-19, which suggests that the effect of COVID-19 on myocardial infarction risk is not substantial. Increased pressure on the Swedish health care system has not led to increased risks or poorer outcomes for patients presenting with acute myocardial infarction.
Note:	Altres ajuts: This work was supported by the Swedish Research Council of Health, Working Life and Welfare (FORTE) [grant number 2021-00451]
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Myocardial infarction ; COVID-19 ; Epidemiological monitoring ; Public health
Published in:	European Journal of Epidemiology, April 2024, ISSN 1573-7284

DOI: 10.1007/s10654-024-01118-4

9 p, 1.3 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Social and Legal Sciences > Centre for Demographic Studies (CED-CERCA)
Articles > Research articles
Articles > Published articles