Epidemiology and Health

Special Articles

Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020: Yeeun Seo, Jenny Moon, Hyeok-Hee Lee, Hyeon Chang Kim, Fumie Kaneko, Sojung Shin, Eunji Kim, Jang-Whan Bae, Byeong-Keuk Kim, Seung Jun Lee, Min Kim, Hokyou Lee; Epidemiol Health. 2024;46:e2024002. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024002

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Abstract

OBJECTIVES
Cardiovascular diseases are a leading cause of mortality worldwide, and acute myocardial infarction (AMI) is particularly fatal condition. We evaluated the incidence and case fatality rates of AMI in Korea from 2011 to 2020.

METHODS

We utilized data from the National Health Insurance Services to calculate crude, age-standardized, and age-specific incidence rates, along with 30-day and 1-year case fatality rates, of AMI from 2011 to 2020. Age-standardized incidence rates were determined using direct standardization to the 2005 population.

RESULTS

The crude incidence rate of AMI per 100,000 person-years consistently increased from 44.7 in 2011 to 68.3 in 2019, before decreasing slightly to 66.2 in 2020. The age-standardized incidence rate of AMI displayed a 19% rise from 2011 to 2019, followed by a slight decline in 2020. The increasing trend for AMI incidence was more pronounced in males than in females. Both 30-day and 1-year case fatality rates remained stable among younger individuals but showed a decrease among older individuals. There was a minor surge in case fatality in 2020, particularly among recurrent AMI cases.

CONCLUSIONS

Over the past decade, the AMI incidence rate in Korea has consistently increased, with a slight downturn in 2020. The case fatality rate has remained relatively stable except for a minor increase in 2020. This study provides data for continuous surveillance, the implementation of targeted interventions, and the advancement of research aimed at AMI in Korea.

Summary

Key Message
This study observed the incidence rate of acute myocardial infarction using data from Korean National Health Insurance Service. From 2011 to 2019, the incidence rate increased, but there was a slight decrease in 2020. Additionally, the fatality rate remained relatively stable throughout the study period, except for an increase in 2020. The study emphasizes the importance of continuous monitoring and preventive strategies for effective management of acute myocardial infarction.

Citations

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American society for preventive cardiology 2024 cardiovascular disease prevention: Highlights and key sessions
Akhil A. Chandra, Carlos Espiche, Maisha Maliha, Salim S Virani, Roger S Blumenthal, Fatima Rodriguez, Nathan D Wong, Martha Gulati, Leandro Slipczuk, Michael D Shapiro
American Journal of Preventive Cardiology.2025; 21: 100919. CrossRef
Estimating Hospitalization Incidence for Ischaemic Heart Disease Using National Health Insurance Claims Data
Su-Jin Lee, Jong-Yeon Kim
Journal of Health Informatics and Statistics.2025; 50(1): 57. CrossRef
Recurrent myocardial infarction as an unsolved problem of evidence-based medicine
S. Yu. Martsevich
Cardiovascular Therapy and Prevention.2024; 23(6): 4019. CrossRef

Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea: Minsung Cho, Hyeok-Hee Lee, Jang-Hyun Baek, Kyu Sun Yum, Min Kim, Jang-Whan Bae, Seung-Jun Lee, Byeong-Keuk Kim, Young Ah Kim, JiHyun Yang, Dong Wook Kim, Young Dae Kim, Haeyong Pak, Kyung Won Kim, Sohee Park, Seng Chan You, Hokyou Lee, Hyeon Chang Kim; Epidemiol Health. 2024;46:e2024001. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024001

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Abstract

OBJECTIVES
The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review.

METHODS

We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm-identified events.

RESULTS

We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

CONCLUSIONS

We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.

Summary

Key Message
In this study, we developed algorithms to identify acute myocardial infarction (AMI) and stroke events from the Korean National Health insurance Service database. To validate them, we conducted retrospective review of medical records across 24 hospitals throughout Korea. The overall positive predictive values for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

Citations

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Constipation and risk of death and cardiovascular events in patients on hemodialysis
Sang Cheol Park, Juyoung Jung, Young Eun Kwon, Song In Baeg, Dong-Jin Oh, Do Hyoung Kim, Young-Ki Lee, Hye Min Choi
Kidney Research and Clinical Practice.2025; 44(1): 155. CrossRef
Incidence and case fatality of stroke in Korea, 2011-2020
Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim
Epidemiology and Health.2023; 46: e2024003. CrossRef

Original Articles

Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction, and angina pectoris in Korean population: Sung Keun Park, Ju Young Jung, Min-Ho Kim, Chang-Mo Oh, Eunhee Ha, Eun Hye Yang, Hyo Choon Lee, Soonsu Shin, Woo Yeon Hwang, Sangho Lee, So Youn Shin, Jae-Hong Ryoo; Epidemiol Health. 2023;45:e2023088. Published online September 30, 2023; DOI: https://doi.org/10.4178/epih.e2023088

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Abstract

OBJECTIVES
Proteinuria is widely used to predict cardiovascular risk. However, there is insufficient evidence to predict how changes in proteinuria may affect the incidence of cardiovascular disease.

METHODS

The study included 265,236 Korean adults who underwent health checkups in 2003-2004 and 2007-2008. They were categorized into 4 groups based on changes in proteinuria (negative: negative → negative; resolved: proteinuria ≥1+ → negative; incident: negative → proteinuria ≥1+; persistent: proteinuria ≥1+ → proteinuria ≥1+). We conducted 6 years of follow-up to identify the risks of developing ischemic heart disease (IHD), acute myocardial infarction (AMI), and angina pectoris according to changes in proteinuria. A multivariate Cox proportional-hazards model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident IHD, AMI, and angina pectoris.

RESULTS

The IHD risk (expressed as HR [95% CI]) was the highest for persistent proteinuria, followed in descending order by incident and resolved proteinuria, compared with negative proteinuria (negative: reference, resolved: 1.211 [95% CI, 1.104 to 1.329], incident: 1.288 [95% CI, 1.184 to 1.400], and persistent: 1.578 [95% CI, 1.324 to 1.881]). The same pattern was associated with AMI (negative: reference, resolved: 1.401 [95% CI, 1.048 to 1.872], incident: 1.606 [95% CI, 1.268 to 2.035], and persistent: 2.069 [95% CI, 1.281 to 3.342]) and angina pectoris (negative: reference, resolved: 1.184 [95% CI, 1.065 to 1.316], incident: 1.275 [95% CI, 1.160 to 1.401], and persistent: 1.554 [95% CI, 1.272 to 1.899]).

CONCLUSIONS

Experiencing proteinuria increased the risks of IHD, AMI, and angina pectoris even after proteinuria resolved.

Summary

Korean summary
- 본 연구의 목적은 요 시험지 검사를 통해 확인된 단백뇨의 3-5년간의 변화 수준에 따른 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 평가하는 것이다. - 지속적으로 단백뇨가 음성인 집단에 (negative proteinuria) 비해서, 단백뇨가 있었다 사라진 집단 (resolved proteinuria), 새로이 단백뇨가 생긴 집단 (incident proteinuria), 지속적으로 단백뇨가 존재하는 집단 (persistent proteinuria)은 유의하게 증가한 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 나타내었다. - 이러한 결과는 단백뇨가 일단 발생한 사람은, 나중에 사라지더라도, 관상 동맥 질환에 대한 위험이 높으며, 이에 대한 관리와 주의가 필요하다는 것을 시사한다.

Key Message
- The present study was to evaluate the risk of incident ischemic heart disease, acute myocardial infarction, and angina pectoris according to changes in urine dipstick proteinuria over 3-5 years. - Compared with persistently negative proteinuria (negative → negative), resolved proteinuria (positive → negative), incident proteinuria (negative → positive), and persistent proteinuria (positive → positive) had the increased risk of ischemic heart disease, acute myocardial infarction, and angina pectoris. - These results suggest that once manifested proteinuria lead to the increased risk of coronary artery disease, regardless of changes in proteinuria.

Citations

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Frequency and sequence of proteinuria positivity and clinical outcomes in patients with diabetes: A nationwide cohort study
Junseok Jeon, Kyungho Lee, Jung Eun Lee, Wooseong Huh, Kyungdo Han, Hye Ryoun Jang
Diabetes, Obesity and Metabolism.2025; 27(6): 3274. CrossRef

Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea: Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim; Epidemiol Health. 2023;45:e2023035. Published online March 15, 2023; DOI: https://doi.org/10.4178/epih.e2023035

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Abstract

OBJECTIVES
Retinal vein occlusion (RVO) is associated with an increased risk of future cardiovascular events. Statin therapy is a key cornerstone in prevention for patients at high cardiovascular risk. However, little is known about the role of statin therapy for patients with RVO. This study evaluated whether statin treatment in patients with RVO was associated with a lower risk of cardiovascular events.

METHODS

A population-based, nested case-control study was conducted with a cohort of newly diagnosed RVO patients without prior cardiovascular disease between 2008 and 2020 using a nationwide health claims database in Korea. From this cohort of RVO patients, we identified cases of cardiovascular events (stroke or myocardial infarction) after RVO and matched controls based on sex, age, insurance type, antiplatelet use, and underlying comorbidities using 1:2 incidence density sampling.

RESULTS

Using a cohort of 142,759 patients with newly diagnosed RVO, we selected 6,810 cases and 13,620 matched controls. A significantly lower risk of cardiovascular events (adjusted odds ratio, 0.604; 95% confidence interval, 0.557 to 0.655) was observed in RVO patients with statin treatment than in those without statin treatment. Statin treatment was associated with a reduced risk for both stroke and myocardial infarction after RVO. Longer statin treatment after RVO was associated with a lower risk for cardiovascular events.

CONCLUSIONS

Statin treatment was associated with a lower risk for future cardiovascular events in patients with newly diagnosed RVO. Further studies are warranted to clarify the potential cardiovascular preventive role of statins in patients with RVO.

Summary

Korean summary
· 망막정맥폐색 환자들은 심뇌혈관질환의 발생 위험이 높다고 알려져 있다. · 이번 연구를 통해 망막정맥폐색의 발생 이후 스타틴을 복용한 환자들에서 심근경색 및 뇌졸중 발생 위험도가 감소함을 확인하였다. · 고위험군인 망막정맥폐색 환자들에서 적극적인 스타틴의 사용이 심뇌혈관질환의 예방에 도움이 될 수 있을 것이다.

Key Message
· Statin was associated with a lower risk of cardiovascular events in RVO patients. · The reduced risk was observed in both stroke and myocardial infarction after RVO. · Statins might be a good candidate for cardiovascular prevention in RVO patients.

Citations

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Oclusión venosa de retina y su asociación con la enfermedad vascular aterosclerótica
María Larrousse Morellón, Yéssica López Loureiro, Susana Ruiz Bilbao
Medicina Clínica.2024; 163(4): 199. CrossRef
Zerumbone Inhibits the Viability, Motility, and Angiogenesis of Human Retinal Microvascular Endothelial Cells (HRCECs) by Inhibiting Vascular Endothelial Growth Factor
Jiexin Yu, Shule Jiang, Yanli Liu
Current Eye Research.2024; 49(11): 1201. CrossRef
Retinal venous occlusion and its association with atherosclerotic vascular disease
María Larrousse Morellón, Yéssica López Loureiro, Susana Ruiz Bilbao
Medicina Clínica (English Edition).2024; 163(4): 199. CrossRef
Retinal Findings and Cardiovascular Risk: Prognostic Conditions, Novel Biomarkers, and Emerging Image Analysis Techniques
Joseph Colcombe, Rusdeep Mundae, Alexis Kaiser, Jacques Bijon, Yasha Modi
Journal of Personalized Medicine.2023; 13(11): 1564. CrossRef

Systematic Review

Non-cancer health risks in firefighters: a systematic review: Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun; Epidemiol Health. 2022;44:e2022109. Published online November 16, 2022; DOI: https://doi.org/10.4178/epih.e2022109

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Abstract

osFirefighters are occupationally exposed to hazardous factors that may increase their risk of disease. However, non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed to identify non-cancer disease risk in firefighters and determine whether the risk differs according to job characteristics. We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Non-randomized Studies version 2.0 was used to assess the quality of evidence. Due to study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2,491 studies, of which 66 met the selection and quality criteria. We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also identified a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder (PTSD) in firefighters compared to other occupational groups. Contradictory results for the risk of PTSD and anxiety disorders related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and PTSD was available. The risk of non-cancer diseases varied depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters’ jobs and ranks differ by country.

Summary

Korean summary
본 연구는 소방관과 비암성 질환과의 직업관련성을 파악하기 위해 체계적 문헌고찰을 수행하였다. 소방관은 근골격계 질환, 협심증, 심근경색, 외상후 스트레스 장애 등 일부 질환에서 일관된 직업관련성이 보고되었다. 하지만 대부분의 연구에서 연구결과가 건강근로자효과의 영향을 보정하지 못하였고 근무형태, 근무조건, 근무강도 등에 따라 일관되지 못한 결과를 보고하고 있다.

Key Message
In firefighters, risks of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder were increased constantly. Due to the failure to avoid the healthy-worker effect, consistent relationship between firefighters and non-cancerous diseases has not been reported.

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Physiological responses to repeated heat exposure under equal work load conditions
Renan Augusto Bortolassi de Oliveira, Anderson Caetano Paulo, Leonardo Farah, Ariel Orlei Michaloski
International Journal of Occupational Safety and Ergonomics.2025; : 1. CrossRef
Organizational health culture in the Korean firefighter intervention studies: a scoping review
Hanbit Jin, Hyungsun Jun, Jisu Ha, Inae Youn, Jungtae Leem
Frontiers in Public Health.2025;[Epub] CrossRef
Work exposome and related disorders of firefighters: an overview of systematized reviews
Alexis Descatha, Hugues Dousseau, Sabrina Pitet, Francis Magnolini, Neil McMillan, Neil Mangelsdorf, Rick Swan, Jean-Marie Steve, Didier Pourret, Marc Fadel
Safety and Health at Work.2025;[Epub] CrossRef
Associations between Recognition and Behaviors Regarding the Use, Washing and Management of Firefighting Protection Suits and Public Health Awareness of Occupational Exposure Risks among Firefighters
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Fire.2024; 7(5): 156. CrossRef

Review

Epidemiology of myocardial infarction in Korea: hospitalization incidence, prevalence, and mortality: Rock Bum Kim, Jang-Rak Kim, Jin Yong Hwang; Epidemiol Health. 2022;44:e2022057. Published online July 12, 2022; DOI: https://doi.org/10.4178/epih.e2022057

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Abstract

Few studies have comprehensively presented epidemiological indicators of myocardial infarction in Korea. However, multiple published articles and open-source secondary data on the epidemiology of myocardial infarction are now available. This review summarized the hospitalization incidence, prevalence, and mortality rate of myocardial infarction in Korea using articles and open-source data from the Health Insurance Service and the Department of Statistics, surveys of sample populations, registries of patients, and other sources. The epidemiological indicators of myocardial infarction were compared between Korea and other high-income countries. The incidence of hospitalization due to myocardial infarction in Korea was 43.2 cases per 100,000 population in 2016 and has consistently increased since 2011. It was 2.4 times higher among men than among women. The estimated prevalence among adults over 30 years of age ranged from 0.34% to 0.70% in 2020; it was higher among men and increased with age. The mortality in 2020, which was 19.3 per 100,000 population in 2020, remained relatively stable in recent years. Mortality was higher among men than among women. Based on representative inpatient registry data, the proportion of ST-elevated myocardial infarction decreased until recently, and the median time from symptom onset to hospital arrival was approximately 2 hours and 30 minutes. The hospitalization incidence, prevalence, and mortality rate of myocardial infarction were lower in Korea than in other countries, although there was an increasing trend. Comprehensive national-level support and surveillance systems are needed to routinely collect accurate epidemiological indicators.

Summary

Korean summary
○우리나라의 심근경색증 발생률은 2016년 기준 인구 10만명 당 43.2명으로 추정되며 2011년 이후 증가하고 있음. ○ 30세 이상 인구에서 심근경색증 유병률은 0.34% (건강보험청구데이터) 또는 1.0% (국민건강영양조사)로 추정됨. ○ 전체인구에서 심근경색증으로 인한 사망률은 2019년 인구 10만명 당 18.8명으로 최근 큰 변화가 없거나 약간 감소하는 추세임.

Key Message
This review article showed the hospitalized incidence, prevalence, mortality, and features on patient registry of myocardial infarction in Korea from published articles and opened data sources.

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A brief report of the economic burden and epidemiological finding of suicide attempts among the older adults in Korea from 2007 to 2021
Seoyoon Lee, Hyung Eun Shin, Rugyeom Lee, Sooyeon Jo, Seung Cheor Lee, Hyeon-Kyoung Cheong, Yong Joo Rhee, In-Hwan Oh
BMC Geriatrics.2025;[Epub] CrossRef
Estimating Hospitalization Incidence for Ischaemic Heart Disease Using National Health Insurance Claims Data
Su-Jin Lee, Jong-Yeon Kim
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Risk of Cardiovascular Disease According to the Precedence Relationship Between Hypertension and Diabetes Mellitus
Junhee Park, Kyungdo Han, Kyuna Lee, Yoosoo Chang, Dong Wook Shin
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Chunying Liu, Chengfei Peng, Xiaodong Jia, Chenghui Yan, Dan Liu, Xiaolin Zhang, Haixu Song, Yaling Han
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The Korean Journal of Medicine.2024; 99(3): 134. CrossRef
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E. P. Kakorina, I. V. Samorodskaya, S. Yu. Martsevich
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Original Articles

Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults: Kyong Sil Park; Epidemiol Health. 2021;43:e2021006. Published online January 3, 2021; DOI: https://doi.org/10.4178/epih.e2021006

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This cross-sectional study based on the health belief model investigated predictors of anticipated coping behavior at myocardial infarction (MI) symptom onset using secondary data from the 2017 Korea Community Health Survey.

METHODS

Modifying variables (socioeconomic, health knowledge, perceived threat) were selected as independent variables and anticipated coping behavior at MI symptom onset as the dependent variable. Calling 911 was classified as the correct anticipated coping behavior, while visiting a hospital or an oriental hospital, calling family, and others were classified as incorrect.

RESULTS

Of 227,740 participants, 83.2% reported correct anticipated coping behaviors. The likelihood of calling 911 was low if participants experienced atypical symptoms (jaw, neck, back, arm, and shoulder pain), even if they were aware of those symptoms. However, 69.9% of participants who were aware of typical symptoms (chest pain) stated that they would call-911. Sex, age, hypertension, dyslipidemia, obesity, and awareness of MI symptoms affected the correct anticipated coping behavior.

CONCLUSIONS

Correct coping abilities among the general public are vitally important for early treatment of MI patients and reduction of hospitalization time. Members of the general public in their 20s and 30s, 60 years of age or older, with cardiovascular risk factors (male sex, hypertension, dyslipidemia, and obesity), and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Emergency medical services should be called without delay if needed, and public relations activities should be carried out to raise awareness that anyone can use emergency medical services.

Summary

Korean summary
심근경색증 증상 발현 시 올바른 대처 행동을 위해 20-39세, 60세 이상, 남성, 고혈압, 이상지질혈증, 비만이 있는 대상자, 심근경색증 증상을 인지하지 못하는 대상자에게 심근경색증의 전형적, 비전형적 증상에 대해 교육해야 한다. 또한, 환자 발생 시 지체없이 응급의료서비스 신고해야하며, 누구나 응급의료서비스를 이용할 수 있도록 인식 전환을 위한 홍보활동을 시행해야 한다.

Key Message
Those in their 20s and 30s, 60 years of age or older, male, with cardiovascular risk factors, and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Public relations activities should be carried out to raise awareness that anyone can use EMS.

Citations

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Application of intensive management of risk awareness combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure
Xiaoli Yin, Cuiping Huang, Binglai Lin
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Kyehwan Kim, Moojun Kim, Chang-Ok Seo, Hangyul Kim, Hye Ree Kim, Min Gyu Kang, Jin-Sin Koh, Jeong Rang Park, Rock Bum Kim, Dong Ryeol Ryu, Jang Hoon Lee, Moo Hyun Kim, Tae-Jin Youn, Dae Woo Hyun, Shin-Jae Kim, Sang Jae Rhee, Sang-Don Park, Young Joon Hong
Journal of Clinical Medicine.2024; 13(16): 4840. CrossRef

Factors affecting awareness of myocardial infarction symptoms among the general public in Korea: Kyong Sil Park; Epidemiol Health. 2020;42:e2020032. Published online May 18, 2020; DOI: https://doi.org/10.4178/epih.e2020032

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS).

METHODS

This is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis.

RESULTS

Of a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors.

CONCLUSIONS

In order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.

Summary

Korean summary
2017년 지역사회건강조사 자료를 분석한 결과, 한국의 심근경색증 증상의 인지율은 42%로 낮은 인식을 보였다. 한국의 지역사회 내 일반인들의 심근경색증 증상의 인지율을 제고하기 위해 성별, 연령, 교육수준, 직업을 고려하여 교육 및 홍보를 실시해야 한다. 그리고, 전형적인 심근경색증 증상뿐만 아니라 비전형적인 심근경색증 증상에 대한 인식에 대한 정부, 교육기관, 의료기관 등의 적극적인 노력이 필요하다. 또한, 금연, 금주, 신체활동 증진에 대한 보건정책적 관리방안과 심혈관질환 위험요인을 가진 대상자들의 지속적인 모니터링 및 관리가 필요하다.

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Behavioral delays in seeking care among post-acute myocardial infarction women: a qualitative study following percutaneous coronary intervention
Vincenza Giordano, Caterina Mercuri, Silvio Simeone, Teresa Rea, Michele Virgolesi, Rita Nocerino, Vincenzo Bosco, Assunta Guillari
Frontiers in Global Women's Health.2025;[Epub] CrossRef
Impact of health awareness on myocardial infarction
Ahmed Magdy, Seham Elmarayed, Bassem Zarif, Mohamed Sabry, Ahmed Alsawah, Mohamed E. Hasan, Khaled M. Ismaeil, Mohamed Salama
Journal of the Egyptian Public Health Association.2025;[Epub] CrossRef
Spontaneous coronary artery dissection in regions of non-Western populations: a systematic literature search and scoping review
Rasha Kaddoura, Ashraf Ahmed, Mohammed Al-Hijji, Fathima Aaysha Cader, Mirvat Alasnag, David Adlam, Salvatore De Rosa
European Heart Journal Open.2025;[Epub] CrossRef
Recognition of Early Cardiovascular Disease Symptoms in Hypertensive and Dyslipidemic Individuals of Icheon, Korea: Insights into Educational Levels and Health Literacy
Jeehye Lee, Dong-Hee Ryu
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Awareness of Myocardial Infarction in Nangarhar Residents: A Community Based Study
Shams Akmal, Ibrahimi Ikramullah , Ahmadzai Hayatullah
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Assessment of myocardial infarctions knowledge, attitudes and beliefs among adults living in Riyadh Saudi Arabia – insights from cross-sectional study
Wajid Syed, Osama Samarkandi, Abdulmajeed A. Alanazi, Nader Alotaibi, Mahmood Basil A. Al-Rawi
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Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study
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Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries
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Korean Circulation Journal.2023; 53(9): 594. CrossRef
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Saad M Alsaab, Ahmed M Almutairi, Ghadi K Alsaadi, Ziyad A Altokhais, Samar H Alabdulqader, Wafa Y Alnofal, Nourah M Alduhaim
Cureus.2023;[Epub] CrossRef
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International Journal of Environmental Research and Public Health.2022; 19(3): 1388. CrossRef
Blood Pressure Awareness and Knowledge of Cardio-Cerebrovascular Diseases in South Korean Women with Hypertension
Yeo Won Jeong
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Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis
Akash Sharma, Karavadi Vidusha, Harshini Suresh, Ajan M. J., Kavinkumar Saravanan, Madhvi Dhamania, Nisha B, Rabbanie Tariq Wani
Korean Circulation Journal.2021; 51(12): 983. CrossRef
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Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey
Ivy Mannoh, Ruth‐Alma Turkson‐Ocran, Jasmine Mensah, Danielle Mensah, Stella S. Yi, Erin D. Michos, Yvonne Commodore‐Mensah
Journal of the American Heart Association.2021;[Epub] CrossRef

Risk factors for heart failure in a cohort of patients with newly diagnosed myocardial infarction: a matched, case-control study in Iran: Ali Ahmadi, Koorosh Etemad, Arsalan Khaledifar; Epidemiol Health. 2016;38:e2016019. Published online May 17, 2016; DOI: https://doi.org/10.4178/epih.e2016019

24,315 View
221 Download
14 Web of Science
11 Crossref

Abstract PDF

Abstract

OBJECTIVES
Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors.

METHODS

In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls. We randomly selected four controls per one case, matched on the date at MI and HF diagnosis, according to incidence density sampling. Using conditional logistic regression models, odds ratios (ORs) with a 95% confidence interval (CI) were calculated to identify potential risk factors.

RESULTS

The one-year in-hospital mortality rate was 18.2% in the cases and higher than in the controls (12.1%) (p<0.05). Significant risk factors for HF were: right bundle branch block (RBBB) (OR, 2.86; 95% CI, 1.95 to 4.19), stroke (OR, 2.00; 95% CI, 1.39 to 2.89), and coronary artery bypass grafting (CABG) (OR, 2.03; 95% CI, 1.34 to 3.09). Diabetes, hypertension, percutaneous coronary intervention (PCI), atrial fibrillation, ventricular tachycardia, and age were determined to be the factors significantly associated with HF incidence (p<0.05). The most important factor in women was diabetes (OR, 1.41; 95% CI, 1.05 to 1.88). Age, hypertension, PCI, CABG, and RBBB were the most important factors in men.

CONCLUSIONS

Our findings may help to better identify and monitor the predictive risk factors for HF in MI patients. The pattern of risk factors was different in men and women.

Summary

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Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database: Hyungseon Yeom, Dae Ryong Kang, Seong Kyung Cho, Seung Won Lee, Dong-Ho Shin, Hyeon Chang Kim; Epidemiol Health. 2015;37:e2015022. Published online May 1, 2015; DOI: https://doi.org/10.4178/epih/e2015022

21,139 View
183 Download
7 Web of Science
8 Crossref

Abstract Summary PDF

Abstract

OBJECTIVES
The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea.

METHODS

The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database.

RESULTS

Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%).

CONCLUSIONS

The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.

Summary

Korean summary
급성심근경색 환자의 급성기 의료이용행태를 조사하기 위해 2007년부터 2011년까지 급성심근경색증 진단명(ICD-10 코드 I21.x)을 포함하는 입원 청구자료 513,886건을 분석하였다. 총 295,001건의 독립된 입원 에피소드를 추출하여 분석한 결과, 5년동안 전체 입원건수와 응급실 경유 입원건수는 감소한 반면, 진단 또는 치료 목적의 침습적 시술을 동반한 입원은 증가하였다. 건강보험청구자료를 이용하여 급성심근경색증 발생 규모를 파악할 때, 진단명만으로는 정확한 추계가 어려우며 관련 시술 등의 의료이용 정보를 추가하는 것이 필요할 것이다.

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