Document Detail

Trends in severity of hospitalized myocardial infarction: the atherosclerosis risk in communities (ARIC) study, 1987-1994.
MedLine Citation:
PMID:  10783222     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Declining mortality rates of coronary heart disease in the United States could be attributable to declining incidence, declining severity, and/or improvements in treatment. METHODS: We examined trends in severity of patients hospitalized for myocardial infarction to characterize its contribution to this decline by using data from the Atherosclerosis Risk in Communities (ARIC) study. RESULTS: No significant change in the proportion having systolic blood pressure <100 mm Hg or an abnormal pulse at presentation was noted. The proportion with ST-segment elevation on the initial electrocardiogram increased 10% per year (P <.001), and the proportion with a diagnostic or evolving diagnostic electrocardiogram abnormality increased 4% per year (P <.01); the proportion that had a new Q-wave infarction develop remained unchanged. The mean peak creatine kinase level decreased 5% per year (P <.001), the proportion with abnormal enzyme levels decreased 10% per year (P <.001), and the proportion that met criteria for definite myocardial infarction decreased 4% per year (P <.05). The proportion that had cardiogenic shock decreased 10.9% per year (P <. 01), but the proportion that had an acute episode of congestive heart failure was stable. CONCLUSIONS: With stable hemodynamic indicators, worsening electrocardiographic indicators, and improving enzymatic indicators, these results provide mixed support for decreases in the severity of myocardial infarction.
D C Goff; G Howard; C H Wang; A R Folsom; W D Rosamond; L S Cooper; L E Chambless
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  139     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-05-30     Completed Date:  2000-05-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  874-80     Citation Subset:  AIM; IM    
Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA.
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MeSH Terms
Coronary Artery Disease / diagnosis,  mortality*,  therapy
Hospitalization / trends*
Middle Aged
Myocardial Infarction / diagnosis,  mortality*,  therapy
Population Surveillance
Risk Assessment
Severity of Illness Index
Survival Rate
United States / epidemiology
Grant Support
Comment In:
Am Heart J. 2000 May;139(5):767-70   [PMID:  10783207 ]

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