Trends in comorbidities and risk factors of patients with first time acute myocardial infarction between 1985 and 2023 - Results of the Myocardial Infarction Registry Augsburg.

Background: For the last 40 years, the Myocardial Infarction Registry Augsburg recorded all cases of hospitalized acute myocardial infarction (AMI) and prehospital coronary artery disease (CAD) deaths. Obesity, hypertension, hyperlipidemia, diabetes mellitus and smoking are important risk factors for CAD and AMI. Methods: We analysed the presence and trends over time of these comorbidities in hospitalized patients with first-time AMI. Results: The prevalence of obesity (BMI > 30 kg/m²) in male and female AMI patients increased steadily from 1985 onwards until today. For hypertension and hyperlipidemia, there was an increase from 1985 until the early 2000s followed by a subsequent decline until 2023. Similarly, after an increase in the first two decades, the prevalence of diabetes in male AMI patients decreased slightly in recent years. For women, the proportion of patients with known diabetes remained unchanged in the first two decades but decreased since the turn of the millennium. While the number of male AMI patients that were current or former smokers did not vary much over time, there was a substantial increase in female patients. Conclusion: The prevalence of important comorbidities in hospitalized AMI patients changed within the past four decades. Especially the steady increase in obesity and smoking in female patients clearly shows that prevention efforts must be intensified to reduce the negative effects not only on coronary but also on cardiovascular and overall health.