Ten-year trends in cardiovascular risk factors among patients hospitalised with acute myocardial infarction in Estonia: a retrospective nationwide observational study.

INTRODUCTION Cardiovascular risk-factor profiles among patients hospitalised with acute myocardial infarction (AMI) can inform surveillance of a high-risk clinical cohort, but do not directly represent risk-factor prevalence in the general population.

Methods

We analysed aggregate annual Estonian AMI registry data for hospitalised AMI patients during 2015-2024. AMI04 risk-factor trends were assessed using ordinary least squares regression, with sensitivity analyses for known status, age-sex standardisation to the pooled hospitalised AMI cohort, COVID-period exclusion, AMI case mix, and national hospitalised AMI burden.

Results

Documented smoking increased from 25.5% in 2015 to 28.1% in 2024 (β = 0.302% points/year; 95% CI 0.014 to 0.590; p = 0.042). The smoking trend remained significant in known-status analyses and after age-sex standardisation, although the crude observed trend became borderline after excluding 2020-2021. Documented dyslipidaemia increased descriptively, but full-period crude and age-sex-standardised trends were borderline, and unknown dyslipidaemia status decreased over time. Annual AMI attacks and national hospitalised AMI burden declined, with concurrent changes in sex and age composition.

Conclusion

Among hospitalised AMI patients in Estonia, documented smoking increased during 2015-2024 and remained consistent in known-status and age-sex-standardised sensitivity analyses. Dyslipidaemia trends require cautious interpretation because unknown status changed over time. These aggregate registry findings describe a selected hospitalised AMI cohort and should not be interpreted as direct evidence of national prevention-policy success or failure.