Ten-Year Incidence of Fatal and Non-Fatal Myocardial Infarction in the Elderly Population of Madrid

Introduction and objectives. To determine the incidence of and mortality due to myocardial infarction and coronary heart disease in the elderly population of Madrid, Spain. Methods. The study involved a population-based cohort of 1297 individuals aged over 64 years without cardiovascular disease who were recruited in 1995. All cases of fatal and non-fatal myocardial infarction recorded up until December 2004 were investigated and classified using WHO-MONICA (World Health Organization-Multinational MONItoring of trends and determinants in CArdiovascular disease) criteria. Results. Men had a significantly higher cumulative incidence of ischemic events (P<.001) and sudden death (P<.001), and a non-significantly higher risk of myocardial infarction (6.30%; 95% confidence interval [CI], 4.33%-8.76%) than women (4.90%; 95% CI, 3.54%-6.70%; P=.181). While the risk of myocardial infarction increased with age (P<.05), gender differences tended to narrow. The incidence was higher in men (889/100 000 person-years) than women (610/100 000 person-years; P<.001) and increased with age (P<.01). This increase was progressive in women but not in men. The mortality rate was also higher in men (472/100 000 person-years; 95% CI, 248-697) than women (328/100 000 person-years; 95% CI, 188-469; P<.001), and was six times higher in the >= 85-year-old age group than in those aged 65-74 years (P<.001). Conclusions. The incidence of fatal and non-fatal myocardial infarction was very high in the elderly population of Madrid. Both incidence and mortality rates increased dramatically with age after 64 years. Rates were higher in men than women at all ages, though gender differences decreased with age.