A 30-Year Perspective (1975–2005) Into the Changing Landscape of Patients Hospitalized With Initial Acute Myocardial Infarction Worcester Heart Attack Study

Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Circulation Cardiovascular Quality and Outcomes (Impact Factor: 5.66). 03/2009; 2(2):88-95. DOI: 10.1161/CIRCOUTCOMES.108.811828
Source: PubMed


The effects of lifestyle changes and evolving treatment practices on coronary disease incidence rates, demographic and clinical profile, and the short-term outcomes of patients hospitalized with acute myocardial infarction have not been well characterized. The purpose of this study was to examine multidecade-long trends (1975-2005) in the incidence rates, demographic and clinical characteristics, treatment practices, and hospital outcomes of patients hospitalized with an initial acute myocardial infarction from a population-based perspective.
Residents of the Worcester, Mass, metropolitan area (median age, 37 years; 89% white) hospitalized with an initial acute myocardial infarction (n=8898) at all greater-Worcester medical centers during 15 annual periods between 1975 and 2005 comprised the sample of interest. The incidence rates of initial acute myocardial infarction were lower in 2005 (209 of 100,000 population) than in 1975 (277 of 100,000), although these trends varied inconsistently over time. Patients hospitalized during the most recent study years were significantly older (mean age, 64 years in 1975; 71 years in 2005), more likely to be women (38% in 1975; 48% in 2005), and have a greater prevalence of comorbidities. Hospitalized patients were increasingly more likely to receive effective cardiac medications and coronary interventional procedures for the period under investigation. Hospital survival rates improved significantly over time (81% survived in 1975; 91% survived in 2005), although varying trends were observed in the occurrence of clinically important complications.
The results of this community-wide investigation provide insight into the changing magnitude, characteristics, management practices, and outcomes of patients hospitalized with a first myocardial infarction.

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    • "Previous studies have suggested that the incidence of CAD and associated mortality has declined in many countries [22, 24–27]. Data from MIYAGI-AMI registry study demonstrated that in the last two decades there was a steady trend of increasing incidence of AMI [23]. "
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    • "Up to 10 million Americans report to an Emergency Department (ED) for chest pain yearly and this number is expected to climb with continued aging of the United States (U.S.) population [1]. The substantial number of emergent hospitalizations for acute coronary syndrome (ACS), including ST-elevation myocardial infarction (STEMI), Non ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA), represents a significant financial strain to both patients and the healthcare system [2,3]. This burden could be ameliorated, and more efficient treatment administered, if a more rapid, sensitive, and specific biomarker could differentiate between the spectrum of ACS (i.e. "
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    10/2013; 2(2):108. DOI:10.4172/2327-4972.1000108
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    • "In brief, during the 5 years under study for the present investigation (1995, 1997, 1999, 2001, and 2003), the medical records of the 11 acute care general hospitals serving residents of the Worcester metropolitan area were searched for patients with a possible discharge diagnosis of AMI. The records were reviewed and validated according to diagnostic cri teria described previously (Floyd et al. 2009; Goldberg et al. 1988), and at least two of the following criteria were required for inclusion in the original study: a suggestive clinical history, increased serum biomarker levels above each hospital's normal range, and serial electrocardiographic findings indicative of AMI. "
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