Changing trends in the long-term prognosis of patients with acute myocardial infarction: a population-based perspective
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Authors
Botkin, Naomi F.Spencer, Frederick A.
Goldberg, Robert J.
Lessard, Darleen M.
Yarzebski, Jorge L.
Gore, Joel M.
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Quantitative Health Sciences
Department of Medicine, Division of Cardiovascular Medicine
Document Type
Journal ArticlePublication Date
2005-12-22Keywords
AgedAged, 80 and over
Female
Humans
Male
Middle Aged
Myocardial Infarction
Prognosis
Risk Factors
Survival Rate
Time Factors
Biostatistics
Epidemiology
Health Services Research
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Show full item recordAbstract
BACKGROUND: Little contemporary data exist describing changes over time in the postdischarge prognosis of hospital survivors of acute myocardial infarction (AMI). The purpose of our study was to examine recent and multidecade-long (1975-2001) trends in the long-term prognosis of greater Worcester (MA) residents discharged from all metropolitan Worcester hospitals after confirmed AMI. METHODS: A total of 9827 greater Worcester residents with independently validated AMI discharged from all metropolitan Worcester hospitals during 13 annual periods between 1975 and 2001 comprised the study population. A variety of follow-up approaches were used to ascertain the survival status of discharged patients through the end of 2003. RESULTS: Crude unadjusted 1-year postdischarge survival rates declined over time. Suggestions of modest improvements in the multivariable adjusted 1-year postdischarge survival rates were noted, however, in patients discharged from greater Worcester hospitals in the more recent (2001) (adjusted odds of surviving 1.23, 95% CI 0.97-1.55) as compared with earliest study periods (1975/1978). Advancing age, female sex, presence of prior diabetes, stroke, heart failure, or myocardial infarction and occurrence of several clinical complications during hospitalization were significantly related to an adverse postdischarge prognosis. CONCLUSIONS: The results of this investigation provide contemporary insights into the long-term survival of patients with AMI from a more generalizable population-based perspective. Multivariable adjusted analyses revealed slight improvements in postdischarge survival over time. Our data identify several high-risk groups that should be targeted for more aggressive surveillance and increased use of effective cardiac therapies and interventions.Source
Am Heart J. 2006 Jan;151(1):199-205. Link to article on publisher's siteDOI
10.1016/j.ahj.2005.03.016Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47638PubMed ID
16368319Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.ahj.2005.03.016