title: Geographical clustering of incident acute myocardial infarction in Denmark: A spatial analysis approach.
abstract: To examine the geographical patterns in AMI and characterize individual and neighborhood sociodemographic factors for persons living inside versus outside AMI clusters.
  
  
  
  The study population comprised 3,515,670 adults out of whom 74,126 persons experienced an incident AMI (2005-2011). Kernel density estimation and global and local clustering methods were used to examine the geographical patterns in AMI. Median differences and frequency distributions of sociodemographic factors were calculated for persons living inside versus outside AMI clusters.
  
  
  
  Global clustering of AMI occurred in Denmark. Throughout the country, 112 significant clusters with high risk of incident AMI were identified. The relative risk of AMI in significant clusters ranged from 1.45 to 47.43 (median=4.84). Individual and neighborhood socioeconomic position was markedly lower for persons living inside versus outside AMI clusters.
  
  
  
  AMI is geographically unequally distributed throughout Denmark and determinants of these geographical patterns might include individual- and neighborhood-level sociodemographic factors.
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, DK-1353 Copenhagen K, Denmark. Electronic address: thok@niph.dk.
authors.forename: Thora Majlund
authors.initials: TM
authors.lastname: Kjærulff
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, DK-1353 Copenhagen K, Denmark. Electronic address: ake@niph.dk.
authors.forename: Annette Kjær
authors.initials: AK
authors.lastname: Ersbøll
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, DK-1353 Copenhagen K, Denmark; Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark; Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, DK-2900 Hellerup, Denmark; The Danish Heart Foundation, Hauser Plads 10, DK-1127 Copenhagen K, Denmark. Electronic address: Gunnar.Gislason@regionh.dk.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gislason
authors.affiliation: Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark . Electronic address: jschipperijn@health.sdu.dk.
authors.forename: Jasper
authors.initials: J
authors.lastname: Schipperijn
mesh_terms: D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis
keywords: Acute myocardial infarction; Clustering; Registers; Socioeconomic position; Spatial statistics