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Temporal Trends of the Incidence of Ischemic Heart Disease in Iran Over 15 Years: A Comprehensive Report from a Multi-Centric Hospital-Based Registry

Authors Nouri F, Feizi A, Taheri M, Mohammadifard N, Khodarahmi S, Sadeghi M, Sarrafzadegan N

Received 25 April 2020

Accepted for publication 19 July 2020

Published 6 August 2020 Volume 2020:12 Pages 847—856

DOI https://doi.org/10.2147/CLEP.S259953

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Eyal Cohen


Fatemeh Nouri,1,2 Awat Feizi,2 Marzieh Taheri,3 Noushin Mohammadifard,4 Somayeh Khodarahmi,5 Masoumeh Sadeghi,6 Nizal Sarrafzadegan7

1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; 3Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 4Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 5Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 6Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 7Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence: Nizal Sarrafzadegan
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran
Tel +983136115310
Fax +983136115303
Email nsarrafzadegan@gmail.com

Background: We sought to explore the temporal trend of ischemic heart disease (IHD) incidence rate (IR) in a large city of Iran.
Methods: The study population comprised hospitalized patients who were living in Isfahan, Iran, with first or recurrent IHD during the period of 2001 to 2016. To identify patients, clinical diagnostic codes were applied according to the International Classification of Diseases 10 (ICD-10: I20.0, I21–I25) and the “World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease” diagnostic categories (WHO-MONICA). Using a direct method, we calculated age-, sex-, and place-of-residence-adjusted incidence rates based on multiple reference populations. To examine the long-term trend for the IR, a bootstrap robust zero-truncated negative binomial regression model was used.
Results: A total of 102,254 hospitalized patients, with a mean (SD) age of 61.85 (12.79), were registered between 2001 and 2016. After an initial reduction from 2006 to 2010, crude and adjusted IRs of IHD increased between 2010 and 2016. We further observed a significant increasing long-term temporal trend in the IR with an average annual change of 1.42% to 3.36% over the study period.
Conclusion: Our findings showed a decreasing trend in the IR of IHD between 2006 and 2010, possibly attributed to the comprehensive community-based interventions named “Isfahan Healthy Heart Program” performed from 2001 to 2007, followed by an increase in the adjusted IR of IHD between 2010 and 2016 in Isfahan; this indicates the importance of continuing the preventive measures to preclude the risk factors of cardiovascular diseases in our population.

Keywords: ischemic heart disease, incidence rate, temporal trend, registry

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