Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994

BACKGROUND AND METHODS: To clarify the determinants of contemporary trends in mortality from coronary heart disease (CHD), we conducted surveillance of hospital admissions for myocardial infarction and of in-hospital and out-of-hospital deaths due to CHD among 35-to-74-year-old residents of four communities of varying size in the United States (a total of 352,481 persons in 1994). Between 1987 and 1994, we estimate that there were 11,869 hospitalizations for myocardial infarction (on the basis of 8572 hospitalizations sampled) and 3407 fatal coronary events (3023 sampled).

RESULTS: The largest average annual decrease in mortality due to CHD occurred among white men (change in mortality, -4.7 percent; 95 percent confidence interval, -2.2 to -7.1 percent), followed by white women (-4.5 percent; 95 percent confidence interval, -0.7 to -8.2 percent), black women (-4.1 percent; 95 percent confidence interval, -10.3 to +2.5 percent), and black men (-2.5 percent; 95 percent confidence interval, -6.9 to +2.2 percent). Overall, in-hospital mortality from CHD fell by 5.1 percent per year, whereas out-of-hospital mortality declined by 3.6 percent per year. There was no evidence of a decline in the incidence of hospitalization for a first myocardial infarction among either men or women; in fact, such hospital admissions increased by 7.4 percent per year (95 percent confidence interval for the change, +0.5 to +14.8 percent) among black women and 2.9 percent per year (95 percent confidence interval, -3.6 to +9.9 percent) among black men. Rates of recurrent myocardial infarction decreased, and survival after myocardial infarction improved.

CONCLUSIONS: From 1987 to 1994, we observed a stable or slightly increasing incidence of hospitalization for myocardial infarction. Nevertheless, there were significant annual decreases in mortality from CHD. The decline in mortality in the four communities we studied may be due largely to improvements in the treatment and secondary prevention of myocardial infarction.

Errataetall:

CommentIn: N Engl J Med. 1998 Sep 24;339(13):915-7. - PMID 9744977

Medienart:

Artikel

Erscheinungsjahr:

1998

Erschienen:

1998

Enthalten in:

Zur Gesamtaufnahme - volume:339

Enthalten in:

The New England journal of medicine - 339(1998), 13 vom: 24. Sept., Seite 861-7

Sprache:

Englisch

Beteiligte Personen:

Rosamond, W D [VerfasserIn]
Chambless, L E [VerfasserIn]
Folsom, A R [VerfasserIn]
Cooper, L S [VerfasserIn]
Conwill, D E [VerfasserIn]
Clegg, L [VerfasserIn]
Wang, C H [VerfasserIn]
Heiss, G [VerfasserIn]

Themen:

Americas
Causes Of Death
Demographic Factors
Developed Countries
Diseases
Heart Diseases
Journal Article
Longitudinal Studies
Mortality
Mortality Decline
Myocardial Infarction
North America
Northern America
Population
Population Dynamics
Research Methodology
Research Support, U.S. Gov't, P.H.S.
Studies
Treatment
United States

Anmerkungen:

Date Completed 24.09.1998

Date Revised 14.11.2007

published: Print

CommentIn: N Engl J Med. 1998 Sep 24;339(13):915-7. - PMID 9744977

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM096836857