temporal trend of short-term mortality in acute myocardial between 2000-2017: a multi-centric iranian registry

Background: the study explores the enduring challenges of cardiovascular disease mortality, emphasizing myocardial infarction rates as a proxy for cardiovascular disease in iran. it analyzes the 28-day mortality trends after acute myocardial infarction (ami) from 2000 to 2017.methods: this retrospective cohort study is based on data from a multi-centric hospital-based registry in isfahan. univariate and multivariate frailty cox regression analyses were performed to identify hazard ratios (hrs) for the 28-day mortality rate of ami based on age, gender, and living region.results: the study enrolled 121,284 patients with an average age of 62.00±12.82 years. older age than 65 years was found to be associated with an increased risk of ami (hr: 3.2, 95% ci: 2.7-3.8 from 2000 to 2002 and hr: 4.6, 95% ci: 3.7-5.7 for 2015-2017). there was also an association between living in the urban region and a decreased risk of ami from 2000 to 2005 (hr: 0.64, 95% ci: 0.46-0.90), from 2000 to 2002 (hr: 0.55, 95% ci: 0.43-0.71 for 2003-2005). results showed that the trend of change in 28-day mortality declined more significantly from 2006 to 2017 compared to 2000-2002. younger age (61.76±12.69 vs 71.12±11.73), female gender (hr:0.77, 95%ci: 0.67,0.89), and living in urban regions (hr: 0.69, 95%ci: (0.52,0.94) were the protective factors for the 28-days mortality rate of ami.conclusion: it can be concluded that 28-day mortality had a descending trend from 2006 to 2017. older age, male gender, and living in a rural region were the risk factors that affected the 28-day mortality rate of ami.