Table 1.
Baseline characteristics over time
| Variable | 1995–96 | 1997–98 | 1999–2000 | 2001–02 | 2003–04 | 2005–06 | 2007–08 | 2009–10 | 2011–12 | 2013–14 | P-valuea |
|---|---|---|---|---|---|---|---|---|---|---|---|
| N | 5567 | 9450 | 11 473 | 11 657 | 11 483 | 11 259 | 11 628 | 11 663 | 11 745 | 9749 | |
| Demographics | |||||||||||
| Age (years) | 71 (61–78) | 71 (60–78) | 71 (60–79) | 71 (60–79) | 70 (59–79) | 70 (60–79) | 69 (60–79) | 69 (60–79) | 69 (60–79) | 69 (60–79) | 0.004 |
| Female | 1899 (34.1%) | 3226 (34.1%) | 4114 (35.9%) | 4189 (35.9%) | 3980 (34.7%) | 3847 (34.2%) | 3871 (33.3%) | 3720 (31.9%) | 3711 (31.6%) | 3070 (31.5%) | <0.001 |
| Risk factors | |||||||||||
| Diabetes mellitus | 1068 (19.2%) | 1821 (19.3%) | 2227 (19.4%) | 2259 (19.4%) | 2223 (19.4%) | 2228 (19.8%) | 2293 (19.7%) | 2300 (19.7%) | 2458 (20.9%) | 1995 (20.5%) | <0.001 |
| Hypertension | 1760 (31.6%) | 3036 (32.1%) | 3980 (34.7%) | 4300 (36.9%) | 4532 (39.5%) | 4990 (44.3%) | 5520 (47.5%) | 6004 (51.5%) | 6289 (53.5%) | 5258 (53.9%) | <0.001 |
| Current smoker | 1305 (25.2%) | 2324 (26.3%) | 2904 (27.3%) | 2962 (27.5%) | 2990 (28.2%) | 2996 (29.4%) | 3181 (29.5%) | 3160 (29.5%) | 3123 (28.8%) | 2448 (26.8%) | <0.001 |
| BMI (kg/m2) | 25.8 (23.6–28.4) | 25.8 (23.8–28.4) | 26.1 (23.8–29.0) | 26.0 (23.7–28.7) | 25.9 (23.8–28.4)] | 25.9 (23.7–28.5) | 26.0 (23.8–28.7) | 26.2 (23.9–29.0) | 26.2 (23.9–29.1)] | 26.3 (23.9–29.2) | <0.001 |
| Cardiovascular disease | |||||||||||
| Previous MI | 1120 (20.1%) | 1898 (20.1%) | 2099 (18.3%) | 2212 (19.0%) | 2134 (18.6%) | 1933 (17.2%) | 1934 (16.6%) | 2061 (17.7%) | 2005 (17.1%) | 1652 (16.9%) | <0.001 |
| Previous PCI | 89 (1.6%) | 247 (2.6%) | 361 (3.1%) | 450 (3.9%) | 592 (5.2%) | 761 (6.8%) | 953 (8.2%) | 1210 (10.4%) | 1264 (10.8%) | 1169 (12.0%) | <0.001 |
| Previous CABG | 133 (2.4%) | 256 (2.7%) | 362 (3.2%) | 447 (3.8%) | 441 (3.8%) | 434 (3.9%) | 468 (4.0%) | 498 (4.3%) | 504 (4.3%) | 409 (4.2%) | <0.001 |
| Previous CHF | 1139 (20.5%) | 1749 (18.5%) | 2130 (18.6%) | 2201 (18.9%) | 2016 (17.6%) | 1881 (16.7%) | 1772 (15.2%) | 1899 (16.3%) | 1970 (16.8%) | 1456 (14.9%) | <0.001 |
| Previous PVD | 192 (3.4%) | 383 (4.1%) | 418 (3.6%) | 465 (4.0%) | 465 (4.0%) | 431 (3.8%) | 399 (3.4%) | 430 (3.7%) | 472 (4.0%) | 402 (4.1%) | 0.45 |
| Previous ischaemic stroke | 421 (7.6%) | 730 (7.7%) | 941 (8.2%) | 1019 (8.7%) | 946 (8.2%) | 939 (8.3%) | 889 (7.6%) | 913 (7.8%) | 929 (7.9%) | 680 (7.0%) | 0.016 |
| Any previous stroke | 460 (8.3%) | 802 (8.5%) | 1020 (8.9%) | 1112 (9.5%) | 1045 (9.1%) | 1266 (11.2%) | 1221 (10.5%) | 1203 (10.3%) | 1204 (10.3%) | 905 (9.3%) | <0.001 |
| Atrial fibrillation on admission | 440 (8.6%) | 795 (8.4%) | 920 (8.1%) | 984 (8.5%) | 902 (7.9%) | 868 (7.7%) | 907 (7.8%) | 859 (7.4%) | 890 (7.6%) | 728 (7.6%) | <0.001 |
| Other disease | |||||||||||
| Previous COPD | 161 (2.9%) | 294 (3.1%) | 406 (3.5%) | 460 (3.9%) | 493 (4.3%) | 540 (4.8%) | 583 (5.0%) | 631 (5.4%) | 658 (5.6%) | 482 (4.9%) | <0.001 |
| Cancer within 3 years | 75 (1.3%) | 108 (1.1%) | 135 (1.2%) | 176 (1.5%) | 167 (1.5%) | 211 (1.9%) | 249 (2.1%) | 280 (2.4%) | 312 (2.7%) | 244 (2.5%) | <0.001 |
| Medication on admission | |||||||||||
| Aspirin | 1371 (24.9%) | 2576 (27.6%) | 3391 (29.8%) | 3657 (31.6%) | 3496 (30.7%) | 3265 (29.3%) | 3180 (27.7%) | 3220 (28.0%) | 3024 (26.1%) | 2403 (25.1%) | <0.001 |
| Dual antiplatelet | 0 (0.0%) | 4 (0.0%) | 30 (0.3%) | 86 (0.7%) | 240 (2.1%) | 316 (2.8%) | 337 (2.9%) | 337 (2.9%) | 304 (2.6%) | 216 (2.3%) | <0.001 |
| Warfarin | 174 (3.2%) | 232 (2.5%) | 314 (2.8%) | 357 (3.1%) | 329 (2.9%) | 310 (2.8%) | 364 (3.2%) | 370 (3.2%) | 378 (3.3%) | 353 (3.7%) | <0.001 |
| Betablocker | 1419 (25.8%) | 2396 (25.7%) | 3224 (28.3%) | 3494 (30.3%) | 3498 (30.8%) | 3365 (30.3%) | 3404 (29.7%) | 3318 (29.0%) | 3267 (28.4%) | 2724 (28.6%) | <0.001 |
| Calcium antagonist | 861 (15.6%) | 1290 (13.8%) | 1572 (13.8%) | 1584 (13.8%) | 1474 (13.0%) | 1442 (13.0%) | 1537 (13.4%) | 1785 (15.6%) | 1865 (16.2%) | 1651 (17.3%) | <0.001 |
| Digoxin | 382 (6.9%) | 514 (5.5%) | 567 (5.0%) | 513 (4.4%) | 370 (3.3%) | 320 (2.9%) | 240 (2.1%) | 188 (1.6%) | 151 (1.3%) | 94 (1.0%) | <0.001 |
| ACEi/ARB | 533 (9.7%) | 1032 (11.1%) | 1396 (12.3%) | 1710 (14.8%) | 2017 (17.7%) | 2244 (20.2%) | 2741 (23.9%) | 3092 (26.9%) | 3272 (28.4%) | 2952 (31.0%) | <0.001 |
| Diuretic | 1240 (22.5%) | 1954 (21.0%) | 2341 (20.6%) | 2408 (20.8%) | 2317 (20.4%) | 2224 (20.0%) | 2213 (19.3%) | 2114 (18.4%) | 1945 (16.9%) | 1500 (15.7%) | <0.001 |
| Statin | 203 (3.7%) | 528 (5.7%) | 956 (8.4%) | 1373 (11.9%) | 1674 (14.7%) | 1884 (16.9%) | 2209 (19.2%) | 2522 (21.9%) | 2509 (21.7%) | 2034 (21.2%) | <0.001 |
| Characteristics on presentation | |||||||||||
| Any pulmonary ralesb | 1951 (36.1%) | 2824 (30.8%) | 3079 (27.9%) | 2663 (24.4%) | 2045 (19.2%) | 1201 (11.6%) | 1069 (10.1%) | 1014 (9.2%) | 888 (7.8%) | 688 (7.3%) | <0.001 |
| Cardiogenic shock | Not available | Not available | Not available | Not available | Not available | 237 (2.2%) | 237 (2.2%) | 319 (2.8%) | 293 (2.5%) | 259 (2.7%) | 0.009 |
| Chest pain | 4796 (93.0%) | 8065 (93.5%) | 9663 (93.6%) | 9541 (92.9%) | 9545 (92.0%) | 10153 (90.8%) | 10468 (90.4%) | 10441 (90.2%) | 10280 (88.7%) | 8561 (88.7%) | <0.001 |
| In-hospital LVEF | |||||||||||
| ≥50% | Not available | 19 (28.4%) | 848 (30.6%) | 1638 (37.2%) | 2473 (40.6%) | 3238 (43.9%) | 3870 (45.1%) | 4208 (46.3%) | 4587 (47.5%) | 3900 (47.7%) | <0.001 |
| 40–49% | Not available | 23 (34.3%) | 1056 (38.1%) | 1522 (34.5%) | 1921 (31.6%) | 2003 (27.2%) | 2388 (27.9%) | 2521 (27.8%) | 2546 (26.4%) | 2142 (26.2%) | |
| 30–39% | Not available | 18 (26.9%) | 619 (22.3%) | 859 (19.5%) | 1163 (19.1%) | 1442 (19.6%) | 1652 (19.3%) | 1650 (18.2%) | 1763 (18.3%) | 1463 (17.9%) | |
| <30% | Not available | 7 (10.4%) | 252 (9.1%) | 388 (8.8%) | 529 (8.7%) | 688 (9.3%) | 66 (7.7%)2 | 704 (7.8%) | 762 (7.9%) | 673 (8.2%) | |
| Reperfusion strategyc | |||||||||||
| Thrombolysis for STEMI | 3426 (61.7%) | 5798 (61.5%) | 6774 (59.2%) | 6118 (53.0%) | 4153 (36.5%) | 1708 (15.2%) | 797 (6.9%) | 670 (5.7%) | 479 (4.1%) | 360 (3.7%) | <0.001 |
| Time onset of symptom to thrombolysis; median (IQR) | 200 (125–340) | 190 (120–325) | 180 (115–310) | 180 (110–310) | 180 (110–312) | (180 (110–347) | 162 (100–299) | 168 (101–293) | 150 (93–290) | 160 (100–300) | <0.001 |
| Primary PCI for STEMI | 251 (4.5%) | 541 (5.7%) | 932 (8.1%) | 1661 (14.4%) | 3446 (30.3%) | 6435 (57.2%) | 8010 (68.9%) | 8511 (73.0%) | 8900 (75.8%) | 7601 (78.0%) | <0.001 |
| Time from symptom to primary PCI; median (IQR) | Not applicable | Not applicable | Not applicable | Not applicable | 211 (140–376) | 207 (135–384) | 200 (128–370) | 193 (125–350) | 190 (121–340) | 190 (125–355) | <0.001 |
| In-hospital medication | |||||||||||
| Glycoprotein 2b-3a-inhibitor use | 61 (5.8%) | 179 (9.0%) | 323 (9.3%) | 788 (16.6%) | 3834 (59.3%) | 5685 (70.2%) | 5670 (63.3%) | 3808 (40.5%) | 1563 (15.9%) | 1126 (13.3%) | <0.001 |
Numbers presented are n (%), or median (IQR) as appropriate.
STEMI, ST-elevation myocardial infarction; PCI, Percutaneous coronary intervention; ACEi/ARB, Angiotensin-converting-enzyme inhibtor/angiotensin receptor blocker; IQR, interquartile range; COPD, chronic obstructive pulmonary disease; BMI, body mass index; LVEF, left ventricular ejection fraction; CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention; PVD, peripheral vascular disease; CHF, congestive heart failure; MI, myocardial infarction.
a
P-values were tested with Jonckheere–Terpstra trend test for categorical variables and with linear-by-linear trend test for continuous data.
b
Pulmonary rales were assessed on admission, but logistics and timing of clinical examination among patients undergoing primary PCI may differ.
c
Further data is available in Supplementary material online, Table S2.