O-18 Trends and predictors of incidence and mortality of acute myocardial infarction in the small island developing state of Barbados

Methods: Information on each AMI diagnosis was collected by the Barbados National Registry for Non-Communicable diseases (BNR) from the island’s only tertiary hospital, the Queen Elizabeth Hospital, and the National Vital Registration Department. Surviving participants were followed-up at 28-days and at 1-year post AMI via telephone and using death records. Age-standardized incidence and mortality rates were calculated. Determinants of mortality during the first month (28-days) were examined in logistic regression models. Median and interquartile range (IQR) were calculated for hospital performance metrics (such as time from pain onset to reperfusion).

Results: In the 10-year period between 2010 and 2019, 4,065 cases of AMI were recorded. The median age of the sample was 73 years (IQR: 61 to 83) and approximately half (47%) were female. Over the 10-year period, agestandardized AMI incidence increased for everyone, with a larger increase among men (women: 3 additional cases per 100,000 each year, 95%CI 1 to 6, p=0.02, men: 6 per 100,000, 95%CI 4 to 8, p<0.001). There was no 10-year increase in 28-day mortality in women, but in men mortality increased each year by 2.5 deaths per 100,000 (95%CI: 0.4 to 4.5; p=0.02). Of the risk factors examined, after adjusting for age and sex, both diabetes and hypertension were associated with higher odds of mortality at 28-days, with odds ratios (95% CI) of 2.97 (2.06,4.27) and 1.84 (1.22,2.78), respectively.

Conclusion: AMI incidence and mortality are broadly increasing, with rates increasing faster among men.