Epidemiology: Acute Coronary Syndrome - Now affecting primarily the oldest populations

Introduction

Acute coronary syndrome is made up of three subtypes: STEMI, NSTEMI, and UA. With the exception of Japan, ACS occurs at similar rates in the seven major markets. Datamonitor estimates that there were 1.2 million incident cases of MI in the seven major markets in 2010 and will be 1.5 million by 2020, and that there were over 1.7 million incident cases of ACS in 2010 and will be 2 million by 2020.

Features and benefits

* Gain insight into market potential, including a robust 10-year forecast of acute coronary syndrome incident cases.
* Understand the key epidemiologic risk factors assocaited with acute coronary syndrome.

Highlights

The incidence of MI is clearly associated with increasing age. In 2010, the estimated number of incident cases of MI increased from approximately 167,770 in those aged less than 50 years to about 356,000 in those age 80 years or more.
On average, there are 1.8 cases of incident MI in men for every one case in women. The exception to this is pattern is Italy where there are only 1.1 cases of incident MI in men for every one case of incident MI in women.
Datamonitor estimates that in the US and the five major EU markets, 36% of cases of ACS are STEMI, 34% are NSTEMI, and 30% are UA. In Japan, Datamonitor estimates that 51% of cases of ACS are STEMI, 10% are NSTEMI, and 39% are UA.

Your key questions answered

* What are the most robust sources for acute coronary syndrome incidence data?
* How will the patient population change over the next decade in the US, Japan, and five major EU markets (France, Germany, Italy, Spain, and the UK)?
* How do changes in population structure and risk factors affect the trends surrounding incident acute coronary syndrome cases?
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Executive Summary
Epidemiology of acute coronary syndrome
Epidemiologic forecast results
OVERVIEW
Catalyst
Summary
DISEASE DEFINITION AND DIAGNOSTIC CRITERIA
Definition of acute coronary syndrome
Myocardial infarction: STEMI and NSTEMI
Unstable angina
Diagnosis of acute coronary syndrome
Electrocardiograph
Biomarker testing
Symptoms
Specific diagnostic criteria used in epidemiologic studies
GLOBAL VARIATION AND HISTORICAL TRENDS
Limited variation across the seven major markets with the exception of Japan
Epidemiologic trends in myocardial infarction and acute coronary syndrome
Stable or slightly declining incidence rates of myocardial infarction in the US
Increases in the incidence of acute myocardial infarction in young Japanese men
European incidence rates are probably declining, but data are scarce
Women experience acute coronary syndrome differently from men
Significant decreases in mortality in the last 50 years
DRIVERS OF ACUTE CORONARY SYNDROME EPIDEMIOLOGY
Risk factors are well known and consistent
Smoking, even passively, is highly associated with heart disease
High blood lipid levels persistently increase the risk of acute coronary syndrome
Obesity is a steadily increasing risk factor for acute coronary syndrome
Diabetics are at increased risk for acute coronary syndrome and poorer outcomes
The mode of family history as a risk factor is unknown
Age at first myocardial infarction is increasing
EPIDEMIOLOGIC FORECASTING OF ACUTE CORONARY SYNDROME
Overview
Subpopulations
US
Sources used
Methods
Sources not used
Japan
Sources used
Methods
Sources not used
France
Sources used
Methods
Sources not used
Germany
Sources used
Methods
Sources not used
Italy
Sources used
Methods
Sources not used
Spain
Sources used
Methods
Sources not used
UK
Sources used
Methods
Sources not used
EPIDEMIOLOGIC RESULTS
Myocardial infarction
Current incident cases and future trends
Segmentation by age and gender
US secondary analysis
Age-standardized incidence rates
Acute coronary syndrome
Current incident cases and future trends
Segmentation by subtype
DISCUSSION
Strengths and limits of Datamonitor’s epidemiologic projections
BIBLIOGRAPHY
Journal papers
Websites
APPENDIX
Module methodology
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