Coronary heart disease is the leading cause of death worldwide; accounting for 17.9 million deaths per year.[6]World Health Organization. Fact sheet: cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Ischemic heart disease (IHD) is the most common cause of cardiovascular death; data from the European Society of Cardiology in 2019 showed that IHD accounted for 38% of cardiovascular disease (CVD) deaths in females and 44% in males.[3]Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-826.
https://academic.oup.com/eurheartj/article/44/38/3720/7243210
http://www.ncbi.nlm.nih.gov/pubmed/37622654?tool=bestpractice.com
[7]Timmis A, Vardas P, Townsend N, et al. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J. 2022 Feb 22;43(8):716-99.
https://academic.oup.com/eurheartj/article/43/8/716/6472699
http://www.ncbi.nlm.nih.gov/pubmed/35016208?tool=bestpractice.com
The incidence and mortality of ischemic heart disease has decreased in high-income countries over the past 30 years, which may be due to better control of risk factors such as hypertension, diabetes, high cholesterol, and smoking.[8]GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1223-49.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566194
http://www.ncbi.nlm.nih.gov/pubmed/33069327?tool=bestpractice.com
However, mortality is increasing in developing and transitional countries, with more than 75% of CVD deaths occurring in developing countries.[6]World Health Organization. Fact sheet: cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
These trends reflect changes in population longevity, urbanization, and lifestyle changes.[6]World Health Organization. Fact sheet: cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Despite the overall reduction in incidence, in the US the estimated incidence is 605,000 new and 200,000 recurrent myocardial infarctions (MIs) annually; according to American Heart Association estimates, every 40 seconds an American will have an MI.[9]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
MI affects both men and women, but tends to occur at a younger age in men. The average age of a person having a first MI is 65.6 years for men and 72 years for women.[9]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
The incidence in women increases after menopause. Women ages under 60 years with ST-elevation myocardial infarction have higher 30-day mortality rates even after adjustment for medications, primary percutaneous coronary intervention, and other coexisting comorbidities.[9]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
[10]Cenko E, Yoon J, Kedev S, et al. Sex differences in outcomes after STEMI: effect modification by treatment strategy and age. JAMA Intern Med. 2018 May 1;178(5):632-9.
http://www.ncbi.nlm.nih.gov/pubmed/29630703?tool=bestpractice.com
About 90% of patients with coronary heart disease report at least one major risk factor, including cigarette smoking, dyslipidemia, hypertension, diabetes, and abdominal obesity.[11]Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):937-52.
http://www.ncbi.nlm.nih.gov/pubmed/15364185?tool=bestpractice.com