Recent Trends in Acute Coronary Heart Disease — Mortality, Morbidity, Medical Care, and Risk Factors

McGovern, Paul G.; Pankow, James S.; Shahar, Eyal; Doliszny, Katherine M.; Folsom, Aaron R.; Blackburn, Henry; Luepker, Russell V.

doi:10.1056/nejm199604043341403

Cited by 623 publications

(282 citation statements)

References 26 publications

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“…Details of the project are described in prior publications. 7,8 In brief, surveys are conducted approximately every 5 years in acutecare hospitals and the patient sample is based on an ICD-9 discharge diagnosis of AMI. The random selection of patient records is determined by computer and medical records are abstracted by trained nurses.…”

Section: Methodsmentioning

confidence: 99%

Relation of Length of Hospital Stay in Acute Myocardial Infarction to Postdischarge Mortality

Berger

Duval

Jacobs

et al. 2008

The American Journal of Cardiology

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Length of hospital stay (LOS) following acute myocardial infarction (AMI) has steadily decreased due both to improved treatments and cost considerations. Early discharge may adversely affect some patients who might benefit from extended monitoring. The Minnesota Heart Survey is a populationbased study of AMI in acute-care hospitals in the Minneapolis-St. Paul metropolitan area. Medical records were abstracted on a random sample of patients hospitalized with AMI in 1985, 1990, 1995, and 2001. Case fatality rates, adjusted for age and gender, were identified using mortality data from the index hospitalization and Minnesota death certificates. 4940 patients with validated AMI were identified from the combined 1985 (n=1306), 1990 (n=1550), 1995 (n=1087), and 2001 (n=515) surveys. The median LOS were 9, 8, 6, and 4 days, respectively. Patients hospitalized ≤4 days formed an increasing proportion of the population increasing from 11% (1985) to 58%(2001). In-hospital case fatality declined from 1985 to 2001 (11.6% to 5.4%, p<0.0001 for trend). There was a significant decline in both 1 month (3.3% to 2.4%, p=0.002 for trend) and 6-month (8.9% to 5.4%, p<0.0001) post-discharge mortality from 1985 to 2001. In conclusion, the progressive and substantial reduction in hospital LOS following AMI in the past 2 decades has not been associated with increased postdischarge mortality. These reductions in LOS are associated with increasing use of effective therapies.

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Section: Methodsmentioning

confidence: 99%

Relation of Length of Hospital Stay in Acute Myocardial Infarction to Postdischarge Mortality

Berger

Duval

Jacobs

et al. 2008

The American Journal of Cardiology

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“…3 This was in part the result of increased efforts to improve acute treatment and secondary prevention strategies. [3][4][5] In the acute phase AMI patients require rapid diagnosis and early reperfusion to minimise infarct size and to prevent complications. Several factors determine treatment delay with its major contributors being patient delay, physician delay and in-hospital delay.…”

mentioning

confidence: 99%

Standardised pre-hospital care of acute myocardial infarction patients: MISSION! guidelines applied in practice

Atary

Visser²,

Dijk³

et al. 2010

NHJL

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Despite significant regional differences in ambulance transportation times no difference in total time from onset of symptoms to arrival at the catheterisation room was found. Peak troponin T was 3.33 (IQR 1.23-7.04) mg/l, hospital stay was 2 (IQR 2-3) days and in-hospital mortality was 2.3%. Twelve percent had 0 known risk factors, 30% had one risk factor, 45% two to three risk factors and 13% had four or more risk factors. No significant differences were observed for AMI risk profiles and medication pre-AMI. Conclusions. This study shows that a standardised regional AMI treatment protocol achieved optimal and uniformly distributed pre-hospital performance in the region 'Hollands-Midden', resulting in minimal time delays regardless of area of residence. Hospital stay was short and in-hospital mortality low. Of the patients, 88% had ≥1 modifiable risk factor. (Neth Heart J 2010;18:408-15.)

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“…10 ED could therefore serve as a predictive symptom for potentially life-threatening CHD or stroke, both of which are leading causes of mortality in industrialized societies. 11 Two recent studies have suggested that ED represents an independent risk factor for future cardiovascular events, even independent of classic risk factors, such as diabetes and hypertension. 12,13 In 2005, we calculated the 10-year risk for CHD or stroke in a cohort of men with known International Index of Erectile Function (IIEF-5) score using the Framingham risk profile.…”

Section: Introductionmentioning

confidence: 99%

Is erectile dysfunction a predictor of cardiovascular events or stroke? A prospective study using a validated questionnaire

Ponholzer

Gutjahr

Temml³

et al. 2009

Int J Impot Res

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Erectile dysfunction (ED) is linked to various cardiovascular risk factors and may therefore serve as a predictor of cardiovascular events. To gain further insight into this relationship, we reviewed all data regarding hospital admission for cardial or cerebral vascular disease that occurred until 2008 in a cohort of men who underwent a health investigation in 2001. Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. In total, 2506 men with a negative history of cardial or cerebral vascular disease were analysed. During the 6.5-year followup, 58 cardiovascular events (2.3%) occurred. Men without ED (IIEF-5 422; n ¼ 1636) at baseline developed a cardiovascular event in 1.9% (n ¼ 32) as compared with 2.9% ( þ 52%; n ¼ 26) in those with ED (IIEF-5 p22; n ¼ 670). In contrast to age (hazard ratio (HR): 1.6; 1.2-1.8 for every decade), hypertension (HR: 1.88; 1.1-3.1) and diabetes (HR: 2.6; 1.2-5.8), ED was not an independent risk factor for a cardiovascular event. Although men with ED were at increased risk for future cardiovascular events, ED was not an age-independent predictor of cardiovascular events in our cohort.

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Recent Trends in Acute Coronary Heart Disease — Mortality, Morbidity, Medical Care, and Risk Factors

Abstract: The recent decline in mortality due to CHD in the Minneapolis-St. Paul metropolitan area can be explained by both the declining incidence of myocardial infarction in the population and the improved survival of patients with myocardial infarction.

Cited by 623 publications

References 26 publications

Relation of Length of Hospital Stay in Acute Myocardial Infarction to Postdischarge Mortality

Relation of Length of Hospital Stay in Acute Myocardial Infarction to Postdischarge Mortality

Standardised pre-hospital care of acute myocardial infarction patients: MISSION! guidelines applied in practice

Is erectile dysfunction a predictor of cardiovascular events or stroke? A prospective study using a validated questionnaire

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