Myocardial Infarction in Iran: Epidemiology, Management, and Prognosis
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Abstract
Background: Cardiovascular diseases, specifically acute myocardial infarction (AMI), are the leading cause of death worldwide. In this review, we explain the characteristics of AMI in Iran.
Methods: We searched PubMed, Google, and Google Scholar for articles containing myocardial infarction, STEMI, and MI+ Iran in English and Persian words.
Results: The age-standardized incidence rate of MI was 73.3 per 100 000. The mean±SD age of patients was 61.20±13.40 years. In-hospital mortality of patients with AMI in the IMIR was 12.1%. Concerning AMI complications reported in the IMIR, 5.8% of patients experienced ventricular tachycardia, and 2.5% experienced ventricular fibrillation. The 1-year mortality rate in the IPACE2 study was 4.3%.
Conclusion: Only a few national studies are available in Iran regarding patients with AMI. A federal surveillance program continuously monitoring and tracking coronary events is essential to improve the general population’s health.
1. Mensah GA, Roth GA, Fuster V. The Global Burden of Cardiovascular Diseases and Risk Factors: 2020 and Beyond. J Am Coll Cardiol 2019;74:2529-2532.
2. Roth GA, Mensah GA, Fuster V. The Global Burden of Cardiovascular Diseases and Risks: A Compass for Global Action. J Am Coll Cardiol 2020;76:2980-2981.
3. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017;70:1-25.
4. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation 2018;138:e618-e651.
5. Noroozian M. The elderly population in iran: an ever growing concern in the health system. Iran J Psychiatry Behav Sci. 2012;6(2):1-6.
6. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Samavat T, Khaledifar A. Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in 2012. East Mediterr Health J 2015;21:5-12. |
7. Fakhri M, Sarokhani D, Ghiasi B, Dehkordi AH. Prevalence of Hypertension in Cardiovascular Disease in Iran: Systematic Review and Meta-Analysis. Int J Prev Med 2020;11:56.
8. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Khaledifar A. Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry. Kardiol Pol 2015;73:451-457.
9. Abdolazimi M, Khosravi A, Sadeghi M, Mohammadian-Hafshejani A, Sarrafzadegan N, Salehiniya H, Golshahi J. Predictive factors of short-term survival from acute myocardial infarction in early and late patients in Isfahan and Najafabad, Iran. ARYA Atheroscler 2016;12:59-67.
10. Mohammadian M, Hosseini S, Salehiniya H, Sadeghi M, Sarrafzadegan N, Roohafza HR, Khazaei S, Soltani S, Sarrafkia A, Golshahi J, Mohammadian-Hafshejani A. Prognostic factors of 28 days survival rate in patients with a first acute myocardial infarction based on gender in Isfahan, Iran (2000-2009). ARYA Atheroscler 2015;11:332-340.
11. Hosseini K, Mortazavi SH, Sadeghian S, Ayati A, Nalini M, Aminorroaya A, Tavolinejad H, Salarifar M, Pourhosseini H, Aein A, Jalali A, Bozorgi A, Mehrani M, Kamangar F. Prevalence and trends of coronary artery disease risk factors and their effect on age of diagnosis in patients with established coronary artery disease: Tehran Heart Center (2005-2015). BMC Cardiovasc Disord 2021;21:477.
12. Farshidi H, Rahimi S, Abdi A, Salehi S, Madani A. Factors Associated With Pre-hospital Delay in Patients With Acute Myocardial Infarction. Iran Red Crescent Med J 2013;15:312-316.
13. Dianati M, Mosavi GA, Hajibagheri A, Alavi NM. The pre-hospital delay in seeking treatment in patients with acute myocardial infarction referring to a central hospital in Kashan, Iran. Indian J Med Sci 2010;64:448-454.
14. Momeni M, Salari A, Shafighnia S, Ghanbari A, Mirbolouk F. Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran. Chin Med J (Engl) 2012;125:3404-3409.
15. Taghaddosi M, Dianati M, Fath Gharib Bidgoli J, Bahonaran J. Delay and its related factors in seeking treatment in patients with acute myocardial infarction. ARYA Atheroscler 2010;6:35-41.
16. Poorhosseini H, Saadat M, Salarifar M, Mortazavi SH, Geraiely B. Pre-Hospital Delay and Its Contributing Factors in Patients with ST-Elevation Myocardial Infarction; a Cross sectional Study. Arch Acad Emerg Med 2019;7:e29.
17. Sezavar SH, Hassanzadeh M, Akhlagh Moayed D, Tabandeh M, Ghasemi M, Abdi S, Firoozi I, Golbidi P, Pourjafari M, Taslimi N, Akhlaghi AA, Hashemian M. Current practice of percutaneous coronary intervention on patients with acute coronary syndrome in Iran: A prospective observational study. Med J Islam Repub Iran 2020;34:13.
18. Kassaian SE, Masoudkabir F, Sezavar H, Mohammadi M, Pourmoghaddas A, Kojuri J, Ghaffari S, Sanaati H, Alaeddini F, Pourmirza B, Mir E; IPACE2 Registry Investigators. Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2). BMJ Open 2015;5:e007786.
19. Moeini M, Mahmoudian SN, Khalifezadeh A, Pour AH. Reviewing time intervals from onset of the symptoms to thrombolytic therapy in patients with ST segment elevation myocardial infarction (STEMI). Iran J Nurs Midwifery Res 2010;15(Suppl 1):379-385.
20. Alishahi Tabriz A, Sohrabi MR, Kiapour N, Yazdani S. Factors Associated with Delay in Thrombolytic Therapy in Patients with ST-Elevation Myocardial Infarction. J Tehran Heart Cent 2012;7:65-71.
21. Nozari Y, Geraiely B, Alipasandi K, Jalali A, Omidi N, Aghajani H, Hajizeinali A, Alidoosti M, Pourhoseini H, Salarifar M, Amirzadegan A, Nematipour E, Nomali M. Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study. JMIR Res Protoc 2019;8:e13161.
22. Khalili H, Talasaz AH, Jenab Y, Salarifar M. Clinical characteristics and risk assessment of ST-segment elevation myocardial infarction patients of an Iranian referral center. J Cardiovasc Med (Hagerstown) 2012;13:708-715.
23. Salarifar M, Askari J, Saadat M, Geraiely B, Omid N, Poorhosseini H, Amirzadegan A, Hajzeinali A, Alidoosti M, Aghajani H, Nozari Y, Nematipoor E. Strategies to Reduce the Door-to-Device Time in ST-Elevation Myocardial Infarction Patients. J Tehran Heart Cent 2019;14:18-27.
24. Anderson JL, Morrow DA. Acute Myocardial Infarction. N Engl J Med 2017;376:2053-2064.
25. Ahmadi A, Khaledifar A, Sajjadi H, Soori H. Relationship between risk factors and in-hospital mortality due to myocardial infarction by educational level: a national prospective study in Iran. Int J Equity Health 2014;13:116.
26. Beyranvand MR, Emami MA, Aliasgari A, Kolahi AA. One-Year Outcome of Patients with Acute Myocardial Infarction. J Tehran Heart Cent 2007;2:229-232.
27. Ghaffari S, Hakim H, Pourafkari L, Asl ES, Goldust M. Twenty-year route of prevalence of risk factors, treatment patterns, complications, and mortality rate of acute myocardial infarction in Iran. Ther Adv Cardiovasc Dis 2013;7:117-122.
28. Abdi S, Haji Aghajani M, Janbabaei G, Noohi F, Kermanchi J, Salarifar M, Geraiely B, Sadeghipour P, Kazemi-Saleh D, Firouzi A, Soleimani A, Mortazavi SH. 24/7 Primary Percutaneous Coronary Intervention as a National Program. Crit Pathw Cardiol 2021;20:81-87.
29. Safi M, Rajabi Moghadam H, Sadeghi R, Saadat H, Namazi MH, Vakili H, Hassantash SA, Motamedi MR. Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction . J Tehran Heart Cent 2009;4:45-48.
30. Hosseini SK, Soleimani A, Karimi AA, Sadeghian S, Darabian S, Abbasi SH, Ahmadi SH, Zoroufian A, Mahmoodian M, Abbasi A. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age. Monaldi Arch Chest Dis 2009;72:71-6.
31. Mohammadian M, Hosseini S, Sadeghi M, Sarrafzadegan N, Salehiniya H, Roohafza H, Khazaei S, Mohammadian-Hafshejani A. Trends of 28 days case fatality rate after first acute myocardial infarction in Isfahan, Iran, from 2000 to 2009. ARYA Atheroscler 2015;11:233-243.
32. Noohi F, Hashemi I, Sanati HR, Peighambari MM, Kiavar M, Maadani M, Bassiri HA, Zahedmehr A, Shakerian F, Firouzi A, Kiani R, Abdi S. In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. ARYA Atheroscler 2016;12:28-34.
33. Saadatagah S, Ghodsi S, Omidi N, Poorhosseini H, Salarifar M, Sadeghian S, Alidoosti M, Kassaian SE, Aghajani H, Mortazavi SH, Hosseini K, Geraiely B. Twelve-Year History of STEMI Management in Tehran Heart Center: Concomitant Reduction of In-Hospital Mortality and Hospitalization Length. Arch Iran Med 2020;23:514-521.
34. Ghadimi H, Bishehsari F, Allameh F, Bozorgi AH, Sodagari N, Karami N, Yaghoubi M, Emami S, Ghadimi F, Haerizadeh BF, Sanati A. Clinical characteristics, hospital morbidity and mortality, and up to 1-year follow-up events of acute myocardial infarction patients: the first report from Iran. Coron Artery Dis 2006;17:585-591.
35. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health 2011;10:9.
2. Roth GA, Mensah GA, Fuster V. The Global Burden of Cardiovascular Diseases and Risks: A Compass for Global Action. J Am Coll Cardiol 2020;76:2980-2981.
3. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017;70:1-25.
4. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation 2018;138:e618-e651.
5. Noroozian M. The elderly population in iran: an ever growing concern in the health system. Iran J Psychiatry Behav Sci. 2012;6(2):1-6.
6. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Samavat T, Khaledifar A. Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in 2012. East Mediterr Health J 2015;21:5-12. |
7. Fakhri M, Sarokhani D, Ghiasi B, Dehkordi AH. Prevalence of Hypertension in Cardiovascular Disease in Iran: Systematic Review and Meta-Analysis. Int J Prev Med 2020;11:56.
8. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Khaledifar A. Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry. Kardiol Pol 2015;73:451-457.
9. Abdolazimi M, Khosravi A, Sadeghi M, Mohammadian-Hafshejani A, Sarrafzadegan N, Salehiniya H, Golshahi J. Predictive factors of short-term survival from acute myocardial infarction in early and late patients in Isfahan and Najafabad, Iran. ARYA Atheroscler 2016;12:59-67.
10. Mohammadian M, Hosseini S, Salehiniya H, Sadeghi M, Sarrafzadegan N, Roohafza HR, Khazaei S, Soltani S, Sarrafkia A, Golshahi J, Mohammadian-Hafshejani A. Prognostic factors of 28 days survival rate in patients with a first acute myocardial infarction based on gender in Isfahan, Iran (2000-2009). ARYA Atheroscler 2015;11:332-340.
11. Hosseini K, Mortazavi SH, Sadeghian S, Ayati A, Nalini M, Aminorroaya A, Tavolinejad H, Salarifar M, Pourhosseini H, Aein A, Jalali A, Bozorgi A, Mehrani M, Kamangar F. Prevalence and trends of coronary artery disease risk factors and their effect on age of diagnosis in patients with established coronary artery disease: Tehran Heart Center (2005-2015). BMC Cardiovasc Disord 2021;21:477.
12. Farshidi H, Rahimi S, Abdi A, Salehi S, Madani A. Factors Associated With Pre-hospital Delay in Patients With Acute Myocardial Infarction. Iran Red Crescent Med J 2013;15:312-316.
13. Dianati M, Mosavi GA, Hajibagheri A, Alavi NM. The pre-hospital delay in seeking treatment in patients with acute myocardial infarction referring to a central hospital in Kashan, Iran. Indian J Med Sci 2010;64:448-454.
14. Momeni M, Salari A, Shafighnia S, Ghanbari A, Mirbolouk F. Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran. Chin Med J (Engl) 2012;125:3404-3409.
15. Taghaddosi M, Dianati M, Fath Gharib Bidgoli J, Bahonaran J. Delay and its related factors in seeking treatment in patients with acute myocardial infarction. ARYA Atheroscler 2010;6:35-41.
16. Poorhosseini H, Saadat M, Salarifar M, Mortazavi SH, Geraiely B. Pre-Hospital Delay and Its Contributing Factors in Patients with ST-Elevation Myocardial Infarction; a Cross sectional Study. Arch Acad Emerg Med 2019;7:e29.
17. Sezavar SH, Hassanzadeh M, Akhlagh Moayed D, Tabandeh M, Ghasemi M, Abdi S, Firoozi I, Golbidi P, Pourjafari M, Taslimi N, Akhlaghi AA, Hashemian M. Current practice of percutaneous coronary intervention on patients with acute coronary syndrome in Iran: A prospective observational study. Med J Islam Repub Iran 2020;34:13.
18. Kassaian SE, Masoudkabir F, Sezavar H, Mohammadi M, Pourmoghaddas A, Kojuri J, Ghaffari S, Sanaati H, Alaeddini F, Pourmirza B, Mir E; IPACE2 Registry Investigators. Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2). BMJ Open 2015;5:e007786.
19. Moeini M, Mahmoudian SN, Khalifezadeh A, Pour AH. Reviewing time intervals from onset of the symptoms to thrombolytic therapy in patients with ST segment elevation myocardial infarction (STEMI). Iran J Nurs Midwifery Res 2010;15(Suppl 1):379-385.
20. Alishahi Tabriz A, Sohrabi MR, Kiapour N, Yazdani S. Factors Associated with Delay in Thrombolytic Therapy in Patients with ST-Elevation Myocardial Infarction. J Tehran Heart Cent 2012;7:65-71.
21. Nozari Y, Geraiely B, Alipasandi K, Jalali A, Omidi N, Aghajani H, Hajizeinali A, Alidoosti M, Pourhoseini H, Salarifar M, Amirzadegan A, Nematipour E, Nomali M. Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study. JMIR Res Protoc 2019;8:e13161.
22. Khalili H, Talasaz AH, Jenab Y, Salarifar M. Clinical characteristics and risk assessment of ST-segment elevation myocardial infarction patients of an Iranian referral center. J Cardiovasc Med (Hagerstown) 2012;13:708-715.
23. Salarifar M, Askari J, Saadat M, Geraiely B, Omid N, Poorhosseini H, Amirzadegan A, Hajzeinali A, Alidoosti M, Aghajani H, Nozari Y, Nematipoor E. Strategies to Reduce the Door-to-Device Time in ST-Elevation Myocardial Infarction Patients. J Tehran Heart Cent 2019;14:18-27.
24. Anderson JL, Morrow DA. Acute Myocardial Infarction. N Engl J Med 2017;376:2053-2064.
25. Ahmadi A, Khaledifar A, Sajjadi H, Soori H. Relationship between risk factors and in-hospital mortality due to myocardial infarction by educational level: a national prospective study in Iran. Int J Equity Health 2014;13:116.
26. Beyranvand MR, Emami MA, Aliasgari A, Kolahi AA. One-Year Outcome of Patients with Acute Myocardial Infarction. J Tehran Heart Cent 2007;2:229-232.
27. Ghaffari S, Hakim H, Pourafkari L, Asl ES, Goldust M. Twenty-year route of prevalence of risk factors, treatment patterns, complications, and mortality rate of acute myocardial infarction in Iran. Ther Adv Cardiovasc Dis 2013;7:117-122.
28. Abdi S, Haji Aghajani M, Janbabaei G, Noohi F, Kermanchi J, Salarifar M, Geraiely B, Sadeghipour P, Kazemi-Saleh D, Firouzi A, Soleimani A, Mortazavi SH. 24/7 Primary Percutaneous Coronary Intervention as a National Program. Crit Pathw Cardiol 2021;20:81-87.
29. Safi M, Rajabi Moghadam H, Sadeghi R, Saadat H, Namazi MH, Vakili H, Hassantash SA, Motamedi MR. Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction . J Tehran Heart Cent 2009;4:45-48.
30. Hosseini SK, Soleimani A, Karimi AA, Sadeghian S, Darabian S, Abbasi SH, Ahmadi SH, Zoroufian A, Mahmoodian M, Abbasi A. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age. Monaldi Arch Chest Dis 2009;72:71-6.
31. Mohammadian M, Hosseini S, Sadeghi M, Sarrafzadegan N, Salehiniya H, Roohafza H, Khazaei S, Mohammadian-Hafshejani A. Trends of 28 days case fatality rate after first acute myocardial infarction in Isfahan, Iran, from 2000 to 2009. ARYA Atheroscler 2015;11:233-243.
32. Noohi F, Hashemi I, Sanati HR, Peighambari MM, Kiavar M, Maadani M, Bassiri HA, Zahedmehr A, Shakerian F, Firouzi A, Kiani R, Abdi S. In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. ARYA Atheroscler 2016;12:28-34.
33. Saadatagah S, Ghodsi S, Omidi N, Poorhosseini H, Salarifar M, Sadeghian S, Alidoosti M, Kassaian SE, Aghajani H, Mortazavi SH, Hosseini K, Geraiely B. Twelve-Year History of STEMI Management in Tehran Heart Center: Concomitant Reduction of In-Hospital Mortality and Hospitalization Length. Arch Iran Med 2020;23:514-521.
34. Ghadimi H, Bishehsari F, Allameh F, Bozorgi AH, Sodagari N, Karami N, Yaghoubi M, Emami S, Ghadimi F, Haerizadeh BF, Sanati A. Clinical characteristics, hospital morbidity and mortality, and up to 1-year follow-up events of acute myocardial infarction patients: the first report from Iran. Coron Artery Dis 2006;17:585-591.
35. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health 2011;10:9.
| Files | ||
| Issue | Vol 18 No 2 (2023): J Teh Univ Heart Ctr | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v18i2.13316 | |
| Keywords | ||
| Myocardial infarction ST-elevation myocardial infarction Iran | ||
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How to Cite
1.
Beyranvand MR, Manhoobi H, Shahraz S, Kolahi A-A. Myocardial Infarction in Iran: Epidemiology, Management, and Prognosis. J Tehran Heart Cent. 2023;18(2):82-86.
