This study documents mortality from acute myocardial infarction (AMI), in hospital and at 1 year, for each of 3 selected 1-year periods in a stable community over a 13-year period beginning in 1979 and continuing into the thrombolytic era, to detect any changes occurring in conjunction with the introduction of new therapies.
Every patient with AMI occurring in a geographically defined stable community (Hamilton, Ontario, Canada) in 3 1-year periods (1979 to 1980 [n=816], 1986 to 1987 [n=816], and 1991 to 1992 [n=831]) was identified and clinically characterized by standardized criteria.
Subsequent in-hospital and 1-year survival were ascertained prospectively.
The 3 cohorts were similar in prognostic factors.
Mean age was progressively greater over the study period from 63 years in 1979 to 1980, to 67 years in 1991 to 1992 (p=0.02).
There was no change in in-hospital mortality rates from 1979 to 1980 (17%) and 1986 to 1987 (16%). However, from 1986 to 1987 and 1991 to 1992, in-hospital mortality decreased from 16% to 9% (p<0.001) and 1-year mortality decreased from 26% to 19% (p<0.001).
For patients who survived the hospital phase of AMI, 1-year mortality did not change and was between 11% and 12% in each of the 3 study periods.
From 1986 to 1987 and 1991 to 1992, there was an increase in the use of thrombolytic therapy from 5% to 44% of patients. (...)
Mots-clés Pascal : Infarctus, Myocarde, Fibrinolytique, Acétylsalicylique acide, Bloquant bêta-adrénergique, Etats Unis, Amérique du Nord, Amérique, Traitement, Mortalité, Evolution, Homme, Salicylés, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Chimiothérapie
Mots-clés Pascal anglais : Infarct, Myocardium, Fibrinolytic, Acetylsalicylic acid, Beta blocking agent, United States, North America, America, Treatment, Mortality, Evolution, Human, Salicylates, Cardiovascular disease, Coronary heart disease, Myocardial disease, Chemotherapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0080213
Code Inist : 002B12B03. Création : 21/05/1997.