Morbidity, mortality, gender and clinical-anamnestic features of recurrent myocardial infarction

Objective of the study: To determine the disease incidence and mortality from recurrent myocardial infarction (RMI) in Tomsk for twenty years (2001–2020), to carry out a gender and clinical-anamnestic analysis of MI episodes registered in 2019 and 2020.

Material and methods. Materials for the study were taken from the data of the WHO epidemiological program «Register of acute myocardial infarction». RMI meant a new ischemic attack that occurred 28 days later and in the fi rst 12 months after index acute myocardial infarction (AMI). For 20 years, 1660 cases of RMI were registered. In 2019–2020, 1748 cases of AMI were noted, including 1078 men (61.7%) and 670 women (38.3%), 148 (13.7%) patients with RMI were identifi ed. This group consisted of 97 men (65.5%) and 51 (34.5%) women. To determine the statistical signifi cance of the diff erences in nominal features, the Pearson criterion for was used. The critical level of signifi cance was taken less than 0.05 (p is the achieved level of signifi cance).

Research results. During the period analyzed, the incidence rate of RMI in Tomsk fluctuated within the range of 0.09–0.28 cases per 1000 inhabitants (for men 0.09–0.35, for women 0.06–0.23 cases per 1000 inhabitants). In dynamics, after a long decline in the incidence of RMI in Tomsk, this indicator increased again, especially among men, although it remained signifi cantly lower than in 2001. During the same period, death was registered in 562 (33.9%) patients with RMI. The mortality rate of patients with RMI did not change notably. Its level was identical in men and in women. In terms of gender, it was more common in men younger than 60 years old — 19.6%, in women it was only 3.9% (p < 0.001). Speaking about people older than 60 years, in men — 80.4%, in women — 96.1% (p < 0.001). Men underwent stenting of coronary arteries more often (51.5% and 33.3%, respectively; p < 0.001). As for the rest parameters, no signifi cant diff erences could have been identifi ed. Patients with RMI are older than patients with primary infarction and usually have comorbidities.

Conclusion. The obtained data indicate the absence of numerous gender diff erences in patients with RMI. Comparison of clinical and anamnestic parameters in patients with primary and recurrent infarction showed that patients with RMI should be considered as more diffi cult cases than those with primary infarction, both in terms of age and case history. The urgency of the RMI problem is indicated by the tendency for an increase in morbidity alongside with maintaining the level of mortality of patients at a fairly high and stable level.

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