Incidence and Prevalence

Global Estimates of Heart Attack Incidence and Prevalence

Cardiovascular diseases (CVDs) represent the number one cause of all mortalities globally, with heart attacks being a major contributor to this burden. According to the World Health Organization, 17 million people die every year from cardiovascular diseases, particularly heart attacks and strokes.

Of these global cardiovascular deaths, 7.6 million are specifically attributed to heart attacks (myocardial infarctions), while 5.7 million are due to stroke. The impact is particularly severe in Europe, where more than half of all deaths are caused by CVDs.

A 2024 study highlights that coronary artery disease (CAD) is increasing globally, now accounting for a third of all deaths worldwide. Myocardial infarctions represent the most severe clinical manifestation of CAD and are among the most dangerous coronary events.

Historical data from 1999 indicated that the incidence of acute myocardial infarction (AMI) showed large regional differences that couldn't be completely explained by classical risk factors. At that time, the 28-day case fatality of AMI remained unacceptably high at 50% on average, despite improved therapeutic possibilities.

Time trends in mortality from ischemic heart disease (IHD) have shown a decrease in most Western European countries and an increase in Eastern Europe. Despite this geographic variation, cardiovascular diseases remain the worldwide leading cause of mortality according to 2024 data.

It's worth noting that 80% of premature deaths from cardiovascular causes could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity. Research from the Vienna Transdanube Aging Study (VITA) found that a history of cerebral and cardiovascular events or smoking was significantly associated with the appearance of CVDs. Both smoking (p = 0.0005, OR 1.57, 95% CI 1.22-2.03) and previous CVDs (p = 0.0003, OR 2.36, 95% CI 1.49-3.76) greatly increase the risk for further cerebral and cardiovascular events, particularly in persons over 75 years.

Acute myocardial infarction is complicated by cardiac rupture in 4% to 24% of all infarction deaths, and approximately 10% of hospital infarction deaths. Nearly one in three patients with acute myocardial infarction had other diagnoses at first medical contact, resulting in less frequent guideline-indicated care and significantly higher mortality rates.

Despite considerable progress in prevention and treatment, a 1999 publication predicted that the incidence and prevalence of IHD would increase in the future due to aging of the population, a trend that appears to be continuing based on more recent data.

Completion Rate of Trials

Recent Studies

Recent Heart Attack Studies

SCORED Trial (2025)

• Sotagliflozin, a dual SGLT1/2 inhibitor, was evaluated in patients with type 2 diabetes and chronic kidney disease

• This double-blind, placebo-controlled, randomized clinical trial with 10,584 patients showed:

• Significantly reduced total major adverse cardiovascular events (MACE) by 23%

• Reduced myocardial infarction rate (1.8 vs 2.7 events per 100 person-years)

• Reduced stroke rate (1.2 vs 1.8 events per 100 person-years)

• The ischemic benefit on both myocardial infarction and stroke has not been previously observed with other SGLT inhibitors

COMMANDER HF Trial (2020)

• Rivaroxaban (2.5 mg twice daily) was tested in patients with heart failure, coronary artery disease, and sinus rhythm
• Efficacy: Fewer patients on rivaroxaban had thromboembolic events including sudden/unwitnessed deaths: 13.1% vs 15.5% (hazard ratio, 0.83)
• When sudden/unwitnessed deaths were excluded, results remained significant: 6.1% vs 7.6% (hazard ratio, 0.80)

ARNI Study (2024)

• Sacubitril/valsartan (ARNI) was compared to benazepril (ACEI) in patients with acute myocardial infarction complicated by moderate-to-severe mitral regurgitation

• Efficacy outcomes:

• Significantly lower NT-proBNP levels at 1 month and beyond

• Improved mitral regurgitant jet area and mitral regurgitant volume

• Significant reductions in left ventricular volumes and improvement in ejection fraction

• Lower rate of heart failure hospitalization (HR = 2.03)

• Safety: Higher rate of hypotension in the ARNI group

TIME Trial (2015)

• Single-center, randomized, open-label study comparing clopidogrel and ticagrelor on coronary microvascular dysfunction in STEMI and NSTEMI patients
• Primary endpoint: Index of microcirculatory resistance (IMR) measured after PCI
• Secondary endpoint: Wall motion score index assessed at 3 months using echocardiography
• Included 152 patients randomized in a 1:1 ratio

T-Flex Registry (2021)

• Observational, multicenter registry of 1,203 patients treated with an ultrathin biodegradable polymer-coated sirolimus-eluting stent
• Primary endpoint: One-year incidence of target lesion failure (TLF)
• Efficacy: TLF at one-year was 6.1% in patients with ST-elevation myocardial infarction

Pioglitazone Study (2011)

• Pioglitazone (PIO), an anti-diabetic agent with anti-inflammatory effects, was studied in patients with ST-segment elevation AMI

• Efficacy outcomes:

• Significantly higher incidence of blush score ≥ 2 (71% vs. 38%)

• Better complete ST-segment resolution (71% vs. 44%)

• No slow flow/no-reflow phenomenon or reperfusion arrhythmia in the PIO group

• Trend toward better improvement of LVEF (48% vs. 41%) and lower peak CK levels