Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry

Søren Korsgaard,1,2 Christian Fynbo Christiansen,1,2 Morten Schmidt,1– 3 Henrik Toft Sørensen1,2 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Department of Cardiology, Aarhus University Hospi...

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Autores principales:	Korsgaard S, Christiansen CF, Schmidt M, Sørensen HT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	acute myocardial infarction bias cardiology cohort epidemiology methodology Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/0ee0028dbd42444abf801a25244e8037
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spelling	oai:doaj.org-article:0ee0028dbd42444abf801a25244e80372021-11-04T19:00:26ZImpact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry1179-1349https://doaj.org/article/0ee0028dbd42444abf801a25244e80372021-11-01T00:00:00Zhttps://www.dovepress.com/impact-of-the-look-back-period-on-identifying-recurrent-myocardial-inf-peer-reviewed-fulltext-article-CLEPhttps://doaj.org/toc/1179-1349Søren Korsgaard,1,2 Christian Fynbo Christiansen,1,2 Morten Schmidt,1– 3 Henrik Toft Sørensen1,2 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Department of Cardiology, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Søren KorsgaardDepartment of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, Aarhus, 8200, DenmarkTel +45 87167212Fax +45 87167215Email soren@clin.au.dkPurpose: Studies examining myocardial infarction (MI) often seek to include only incident MIs by excluding recurrent MIs. When based on historical data, identification of previous MI depends on the length of the look-back period. However, international registries often cover a short time period, consequently containing left-censored data, making it impossible to determine if a first MI in a period is truly an incident MI. We evaluated whether the proportion of MIs identified as recurrent MIs depends on the look-back period, and how including recurrent MIs in a planned incident MI cohort impacts survival estimates.Patients and Methods: We used the Danish National Patient Registry, covering all Danish hospitals since 1977 to identify first MIs during 2010– 2016 (index events). The hospital registry history preceding the index event was then searched for previous MIs. We plotted the proportion of index events identified as recurrent MIs as a function of the look-back period. Moreover, we calculated 5-year all-cause mortality and confidence intervals (CIs) using the 1-Kaplan–Meier method for five cohorts based on the index events and defined by look-back periods of 0, 5, 10, 20, and up to 39 years.Results: Among 63,885 index events, 3.4% were identified as recurrent MIs with 5 years of look-back, 7.9% with 10 years, 14% with 24 years, and 15% with up to 39 years. All-cause mortality risk was 36% (95% CI: 36– 37%) with 0 years of look-back, 35% (95% CI: 35– 36%) with 5 years, 35% (95% CI: 35– 36%) with 10 years, 34% (95% CI: 34– 35%) with 20 years, and 34% (95% CI: 33– 34%) with up to 39 years.Conclusion: Most recurrent MIs were identified with a look-back period of 24 years. Including recurrent MIs in a planned incident MI cohort, due to shorter look-back periods, overestimated the mortality risk.Keywords: acute myocardial infarction, bias, cardiology, cohort, epidemiology, methodologyKorsgaard SChristiansen CFSchmidt MSørensen HTDove Medical Pressarticleacute myocardial infarctionbiascardiologycohortepidemiologymethodologyInfectious and parasitic diseasesRC109-216ENClinical Epidemiology, Vol Volume 13, Pp 1051-1059 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute myocardial infarction bias cardiology cohort epidemiology methodology Infectious and parasitic diseases RC109-216
spellingShingle	acute myocardial infarction bias cardiology cohort epidemiology methodology Infectious and parasitic diseases RC109-216 Korsgaard S Christiansen CF Schmidt M Sørensen HT Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
description	Søren Korsgaard,1,2 Christian Fynbo Christiansen,1,2 Morten Schmidt,1– 3 Henrik Toft Sørensen1,2 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Department of Cardiology, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Søren KorsgaardDepartment of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, Aarhus, 8200, DenmarkTel +45 87167212Fax +45 87167215Email soren@clin.au.dkPurpose: Studies examining myocardial infarction (MI) often seek to include only incident MIs by excluding recurrent MIs. When based on historical data, identification of previous MI depends on the length of the look-back period. However, international registries often cover a short time period, consequently containing left-censored data, making it impossible to determine if a first MI in a period is truly an incident MI. We evaluated whether the proportion of MIs identified as recurrent MIs depends on the look-back period, and how including recurrent MIs in a planned incident MI cohort impacts survival estimates.Patients and Methods: We used the Danish National Patient Registry, covering all Danish hospitals since 1977 to identify first MIs during 2010– 2016 (index events). The hospital registry history preceding the index event was then searched for previous MIs. We plotted the proportion of index events identified as recurrent MIs as a function of the look-back period. Moreover, we calculated 5-year all-cause mortality and confidence intervals (CIs) using the 1-Kaplan–Meier method for five cohorts based on the index events and defined by look-back periods of 0, 5, 10, 20, and up to 39 years.Results: Among 63,885 index events, 3.4% were identified as recurrent MIs with 5 years of look-back, 7.9% with 10 years, 14% with 24 years, and 15% with up to 39 years. All-cause mortality risk was 36% (95% CI: 36– 37%) with 0 years of look-back, 35% (95% CI: 35– 36%) with 5 years, 35% (95% CI: 35– 36%) with 10 years, 34% (95% CI: 34– 35%) with 20 years, and 34% (95% CI: 33– 34%) with up to 39 years.Conclusion: Most recurrent MIs were identified with a look-back period of 24 years. Including recurrent MIs in a planned incident MI cohort, due to shorter look-back periods, overestimated the mortality risk.Keywords: acute myocardial infarction, bias, cardiology, cohort, epidemiology, methodology
format	article
author	Korsgaard S Christiansen CF Schmidt M Sørensen HT
author_facet	Korsgaard S Christiansen CF Schmidt M Sørensen HT
author_sort	Korsgaard S
title	Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
title_short	Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
title_full	Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
title_fullStr	Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
title_full_unstemmed	Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry
title_sort	impact of the look-back period on identifying recurrent myocardial infarctions in the danish national patient registry
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/0ee0028dbd42444abf801a25244e8037
work_keys_str_mv	AT korsgaards impactofthelookbackperiodonidentifyingrecurrentmyocardialinfarctionsinthedanishnationalpatientregistry AT christiansencf impactofthelookbackperiodonidentifyingrecurrentmyocardialinfarctionsinthedanishnationalpatientregistry AT schmidtm impactofthelookbackperiodonidentifyingrecurrentmyocardialinfarctionsinthedanishnationalpatientregistry AT sørensenht impactofthelookbackperiodonidentifyingrecurrentmyocardialinfarctionsinthedanishnationalpatientregistry
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Impact of the Look-Back Period on Identifying Recurrent Myocardial Infarctions in the Danish National Patient Registry

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