Coronaire hartziekten, steeds later en vaker chronisch*

Background

To identify age- and gender-specific trends in hospital admissions due to acute myocardial infarction, unstable angina and chronic coronary heart disease in the Netherlands between 1998 and 2007.

Design

Record-linkage cohort study.

Method

By linking data from the population register to the national hospital register we determined for the years 1998 and 2007 the incidence of hospitalization rates with acute myocardial infarction (ICD-9 410), unstable angina (411, 413) or chronic coronary heart disease (412, 414) as primary diagnosis. We analyzed a total of 136,568 hospital admissions, 36,804 of which were due to acute myocardial infarction, 58,475 due to unstable angina and 41,289 due to chronic coronary heart disease.

Results

The proportion of unstable angina remained the same between 1998 and 2007 at 40% in men and 50% in women, while chronic coronary heart disease rose from 29% to 36% in men and from 23% to 30% in women and acute myocardial infarction declined from 30% to 24% in men and from 27% to 22% in women. The average age at admission was higher in 2007 than in 1998, and we saw a decline in admission rates in younger age categories as compared to an increase in older age categories. For chronic coronary heart disease, this turning point was at 65 years of age, for unstable angina at 75 years of age and for acute myocardial infarction at 95 years of age.

Conclusion

Between 1998 and 2007, two shifts in hospital admissions occurred due to coronary heart disease in the Netherlands. Firstly, an increasing proportion was for chronic forms of coronary heart disease, and secondly, the average age of admitted patients increased.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.