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Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective
OBJECTIVES The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI). BACKGROUND Limited data ar...
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| Published in: | Journal of the American College of Cardiology 2001-05, Vol.37 (6), p.1571-1580 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Furman, Mark I Dauerman, Harold L Goldberg, Robert J Yarzbeski, Jorge Lessard, Darleen Gore, Joel M |
| description | OBJECTIVES
The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI).
BACKGROUND
Limited data are available describing trends in the incidence and mortality from an initial QWMI and NQWMI from a multi-hospital community-wide perspective.
METHODS
Our study was an observational study of 5,832 metropolitan Worcester, Massachusetts residents (1990 census = 437,000) hospitalized with validated initial acute MI in all greater Worcester hospitals during 11 annual periods between 1975 and 1997.
RESULTS
The incidence of QWMI progressively decreased between 1975/78 (incidence rate = 171/100,000 population) and 1997 (101/100,000 population). In contrast, the incidence of NQWMI progressively increased between 1975/78 (62/100,000 population) and 1997 (131/100,000 population). Hospital death rates were 19.5% for patients with QWMI and 12.5% for those with NQWMI. After controlling for various covariates, patients with QWMI remained at significantly increased risk for hospital mortality (adjusted odds ratio = 1.63; 95% confidence interval: 1.35, 1.97). While the hospital mortality of QWMI has progressively declined over time (1975/78 = 24%; 1997 = 14%), the in-hospital mortality for NQWMI has remained the same (1975/78 = 12%; 1997 = 12%). These trends remained after adjusting for potentially confounding prognostic factors. The multivariable adjusted two-year mortality after hospital discharge declined over time for patients with QWMI and NQWMI.
CONCLUSIONS
Despite impressive declines in the incidence, in-hospital and long-term mortality associated with QWMI, NQWMI is increasing in frequency and has the same in-hospital mortality now as it did 22 years ago. |
| doi_str_mv | 10.1016/S0735-1097(01)01203-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70844033</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735109701012037</els_id><sourcerecordid>70844033</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490t-1fda609bbf9627c3ed52ec7881c4d661690c37190b3ea2921ffe11e2914c86f93</originalsourceid><addsrcrecordid>eNqFkV1rFDEUhgdR7Lb6E5SAIC00mjOZSSbeSCl-QcEL63XIZk5sZGayTbK7zH_0R5n9YL30Kgl53nMO56mqV8DeAQPx_geTvKXAlLxkcMWgZpzKJ9UC2rajvFXyabU4IWfVeUq_GWOiA_W8OgPgTcuFXFR_7rc45ZnmbSAzmkguQcmW5EBAKXlFcsSpT8RPJD9gOazvcbJ4Xa70IaSVz2YgZurJEKZfNGMciTUJiTPlw-eZRJMxERfDWCI--4I_0q3Z4D41hYken-McrIn9DvCTM9FmH6YPxJBxPWR_anZNbBjHdSk1020ZhqwwphUWeoMvqmfODAlfHs-L6ufnT_e3X-nd9y_fbm_uqG0UyxRcbwRTy6VTopaWY9_WaGXXgW16IUAoZrkExZYcTa1qcA4BsFbQ2E44xS-qt4e6qxge15iyHn2yOAxmwrBOWrKuaRjnBWwPoI0hpYhOr6IfTZw1ML3TqPca9c6RZqD3GrUsudfHBuvliP2_1NFbAd4cAZOsGVw0xUw6cUp0SopCfTxQWJax8Rh1sn6nr_exbEz3wf9nkL-Q4Lus</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70844033</pqid></control><display><type>article</type><title>Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective</title><source>BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS</source><creator>Furman, Mark I ; Dauerman, Harold L ; Goldberg, Robert J ; Yarzbeski, Jorge ; Lessard, Darleen ; Gore, Joel M</creator><creatorcontrib>Furman, Mark I ; Dauerman, Harold L ; Goldberg, Robert J ; Yarzbeski, Jorge ; Lessard, Darleen ; Gore, Joel M</creatorcontrib><description>OBJECTIVES
The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI).
BACKGROUND
Limited data are available describing trends in the incidence and mortality from an initial QWMI and NQWMI from a multi-hospital community-wide perspective.
METHODS
Our study was an observational study of 5,832 metropolitan Worcester, Massachusetts residents (1990 census = 437,000) hospitalized with validated initial acute MI in all greater Worcester hospitals during 11 annual periods between 1975 and 1997.
RESULTS
The incidence of QWMI progressively decreased between 1975/78 (incidence rate = 171/100,000 population) and 1997 (101/100,000 population). In contrast, the incidence of NQWMI progressively increased between 1975/78 (62/100,000 population) and 1997 (131/100,000 population). Hospital death rates were 19.5% for patients with QWMI and 12.5% for those with NQWMI. After controlling for various covariates, patients with QWMI remained at significantly increased risk for hospital mortality (adjusted odds ratio = 1.63; 95% confidence interval: 1.35, 1.97). While the hospital mortality of QWMI has progressively declined over time (1975/78 = 24%; 1997 = 14%), the in-hospital mortality for NQWMI has remained the same (1975/78 = 12%; 1997 = 12%). These trends remained after adjusting for potentially confounding prognostic factors. The multivariable adjusted two-year mortality after hospital discharge declined over time for patients with QWMI and NQWMI.
CONCLUSIONS
Despite impressive declines in the incidence, in-hospital and long-term mortality associated with QWMI, NQWMI is increasing in frequency and has the same in-hospital mortality now as it did 22 years ago.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(01)01203-7</identifier><identifier>PMID: 11345367</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Analysis of Variance ; Angina, Unstable - diagnosis ; Angina, Unstable - mortality ; Angina, Unstable - therapy ; Biological and medical sciences ; Cardiology. Vascular system ; Confounding Factors (Epidemiology) ; Coronary heart disease ; Electrocardiography ; Female ; Heart ; Hospital Mortality - trends ; Humans ; Incidence ; Male ; Massachusetts - epidemiology ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Odds Ratio ; Population Surveillance ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Time Factors ; Urban Health - statistics & numerical data</subject><ispartof>Journal of the American College of Cardiology, 2001-05, Vol.37 (6), p.1571-1580</ispartof><rights>2001 American College of Cardiology</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-1fda609bbf9627c3ed52ec7881c4d661690c37190b3ea2921ffe11e2914c86f93</citedby><cites>FETCH-LOGICAL-c490t-1fda609bbf9627c3ed52ec7881c4d661690c37190b3ea2921ffe11e2914c86f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=968976$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11345367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Furman, Mark I</creatorcontrib><creatorcontrib>Dauerman, Harold L</creatorcontrib><creatorcontrib>Goldberg, Robert J</creatorcontrib><creatorcontrib>Yarzbeski, Jorge</creatorcontrib><creatorcontrib>Lessard, Darleen</creatorcontrib><creatorcontrib>Gore, Joel M</creatorcontrib><title>Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI).
BACKGROUND
Limited data are available describing trends in the incidence and mortality from an initial QWMI and NQWMI from a multi-hospital community-wide perspective.
METHODS
Our study was an observational study of 5,832 metropolitan Worcester, Massachusetts residents (1990 census = 437,000) hospitalized with validated initial acute MI in all greater Worcester hospitals during 11 annual periods between 1975 and 1997.
RESULTS
The incidence of QWMI progressively decreased between 1975/78 (incidence rate = 171/100,000 population) and 1997 (101/100,000 population). In contrast, the incidence of NQWMI progressively increased between 1975/78 (62/100,000 population) and 1997 (131/100,000 population). Hospital death rates were 19.5% for patients with QWMI and 12.5% for those with NQWMI. After controlling for various covariates, patients with QWMI remained at significantly increased risk for hospital mortality (adjusted odds ratio = 1.63; 95% confidence interval: 1.35, 1.97). While the hospital mortality of QWMI has progressively declined over time (1975/78 = 24%; 1997 = 14%), the in-hospital mortality for NQWMI has remained the same (1975/78 = 12%; 1997 = 12%). These trends remained after adjusting for potentially confounding prognostic factors. The multivariable adjusted two-year mortality after hospital discharge declined over time for patients with QWMI and NQWMI.
CONCLUSIONS
Despite impressive declines in the incidence, in-hospital and long-term mortality associated with QWMI, NQWMI is increasing in frequency and has the same in-hospital mortality now as it did 22 years ago.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Angina, Unstable - diagnosis</subject><subject>Angina, Unstable - mortality</subject><subject>Angina, Unstable - therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Confounding Factors (Epidemiology)</subject><subject>Coronary heart disease</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Massachusetts - epidemiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Odds Ratio</subject><subject>Population Surveillance</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Urban Health - statistics & numerical data</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqFkV1rFDEUhgdR7Lb6E5SAIC00mjOZSSbeSCl-QcEL63XIZk5sZGayTbK7zH_0R5n9YL30Kgl53nMO56mqV8DeAQPx_geTvKXAlLxkcMWgZpzKJ9UC2rajvFXyabU4IWfVeUq_GWOiA_W8OgPgTcuFXFR_7rc45ZnmbSAzmkguQcmW5EBAKXlFcsSpT8RPJD9gOazvcbJ4Xa70IaSVz2YgZurJEKZfNGMciTUJiTPlw-eZRJMxERfDWCI--4I_0q3Z4D41hYken-McrIn9DvCTM9FmH6YPxJBxPWR_anZNbBjHdSk1020ZhqwwphUWeoMvqmfODAlfHs-L6ufnT_e3X-nd9y_fbm_uqG0UyxRcbwRTy6VTopaWY9_WaGXXgW16IUAoZrkExZYcTa1qcA4BsFbQ2E44xS-qt4e6qxge15iyHn2yOAxmwrBOWrKuaRjnBWwPoI0hpYhOr6IfTZw1ML3TqPca9c6RZqD3GrUsudfHBuvliP2_1NFbAd4cAZOsGVw0xUw6cUp0SopCfTxQWJax8Rh1sn6nr_exbEz3wf9nkL-Q4Lus</recordid><startdate>20010501</startdate><enddate>20010501</enddate><creator>Furman, Mark I</creator><creator>Dauerman, Harold L</creator><creator>Goldberg, Robert J</creator><creator>Yarzbeski, Jorge</creator><creator>Lessard, Darleen</creator><creator>Gore, Joel M</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010501</creationdate><title>Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective</title><author>Furman, Mark I ; Dauerman, Harold L ; Goldberg, Robert J ; Yarzbeski, Jorge ; Lessard, Darleen ; Gore, Joel M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-1fda609bbf9627c3ed52ec7881c4d661690c37190b3ea2921ffe11e2914c86f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Angina, Unstable - diagnosis</topic><topic>Angina, Unstable - mortality</topic><topic>Angina, Unstable - therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Confounding Factors (Epidemiology)</topic><topic>Coronary heart disease</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Hospital Mortality - trends</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Massachusetts - epidemiology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Odds Ratio</topic><topic>Population Surveillance</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Urban Health - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Furman, Mark I</creatorcontrib><creatorcontrib>Dauerman, Harold L</creatorcontrib><creatorcontrib>Goldberg, Robert J</creatorcontrib><creatorcontrib>Yarzbeski, Jorge</creatorcontrib><creatorcontrib>Lessard, Darleen</creatorcontrib><creatorcontrib>Gore, Joel M</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Furman, Mark I</au><au>Dauerman, Harold L</au><au>Goldberg, Robert J</au><au>Yarzbeski, Jorge</au><au>Lessard, Darleen</au><au>Gore, Joel M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2001-05-01</date><risdate>2001</risdate><volume>37</volume><issue>6</issue><spage>1571</spage><epage>1580</epage><pages>1571-1580</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>OBJECTIVES
The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI).
BACKGROUND
Limited data are available describing trends in the incidence and mortality from an initial QWMI and NQWMI from a multi-hospital community-wide perspective.
METHODS
Our study was an observational study of 5,832 metropolitan Worcester, Massachusetts residents (1990 census = 437,000) hospitalized with validated initial acute MI in all greater Worcester hospitals during 11 annual periods between 1975 and 1997.
RESULTS
The incidence of QWMI progressively decreased between 1975/78 (incidence rate = 171/100,000 population) and 1997 (101/100,000 population). In contrast, the incidence of NQWMI progressively increased between 1975/78 (62/100,000 population) and 1997 (131/100,000 population). Hospital death rates were 19.5% for patients with QWMI and 12.5% for those with NQWMI. After controlling for various covariates, patients with QWMI remained at significantly increased risk for hospital mortality (adjusted odds ratio = 1.63; 95% confidence interval: 1.35, 1.97). While the hospital mortality of QWMI has progressively declined over time (1975/78 = 24%; 1997 = 14%), the in-hospital mortality for NQWMI has remained the same (1975/78 = 12%; 1997 = 12%). These trends remained after adjusting for potentially confounding prognostic factors. The multivariable adjusted two-year mortality after hospital discharge declined over time for patients with QWMI and NQWMI.
CONCLUSIONS
Despite impressive declines in the incidence, in-hospital and long-term mortality associated with QWMI, NQWMI is increasing in frequency and has the same in-hospital mortality now as it did 22 years ago.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11345367</pmid><doi>10.1016/S0735-1097(01)01203-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0735-1097 1558-3597 |
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| subjects | Aged Analysis of Variance Angina, Unstable - diagnosis Angina, Unstable - mortality Angina, Unstable - therapy Biological and medical sciences Cardiology. Vascular system Confounding Factors (Epidemiology) Coronary heart disease Electrocardiography Female Heart Hospital Mortality - trends Humans Incidence Male Massachusetts - epidemiology Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - diagnosis Myocardial Infarction - mortality Myocardial Infarction - therapy Odds Ratio Population Surveillance Prognosis Proportional Hazards Models Retrospective Studies Risk Factors Survival Analysis Time Factors Urban Health - statistics & numerical data |
| title | Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective |
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