Navigation Links
Explaining trends in heart attack

Explaining trends in heart attack: prevention has improved, mortality rates are down, hospitalisation remains the same

A report in Circulation from the Framingham Heart Study, which compared acute myocardial infarction (AMI) incidence in 9824 men and women over four decades, has proposed an explanation for the apparent paradox of improved prevention, falling mortality rates but stable rates of hospitalisation.(1) The study found that over the past 40 years rates of AMI diagnosed by ECG decreased by 50%, whereas rates of AMI diagnosed exclusively by infarction biomarkers doubled. This "evolving" diagnosis of AMI, say the investigators, "offers an explanation for the apparently steady national AMI rates in the face of improvements in primary prevention".

However, the investigators emphasise that this study like others before it highlights a "40-50%" reduction in heart disease mortality in the USA from 1968 to 2000 and a 50% decline in the incidence of AMI when diagnosed by ECG. This, they propose, "implies that primary prevention efforts have influenced the incidence of AMI". That the incidence of hospitalised AMI has not similarly declined is explained by the greater sensitivity of diagnostic AMI biomarkers; they note, for example, that the detection rate of AMI by troponin was higher than in earlier decades.

Another explanation for the decline in AMI mortality rates may be found in a second report from the same Circulation issue.(2) A cohort study of more than 13,000 residents of Worcester, USA, hospitalised with AMI found that the incidence of cardiogenic shock, the most common complication of AMI associated with fatality, declined throughout the 30-year study period. "The results of our study suggest that patients hospitalized with AMI in the 2000s were less likely to develop cardiogenic shock than greater Worcester residents hospitalized with AMI during earlier study years," the investigators report. Cardiogenic shock results from failure of the ventricles to provide adequate circulation of blood.

Commenting on behalf of the European Society of Cardiology, Professor Frans Van de Werf, Chairman of the Cardiology Department at the University Hospital, Leuven, Belgium, said: "These papers are indeed very helpful for understanding trends reported in recent epidemiological studies of AMI. The data underline the critical importance of the definition of an AMI. The increasing use of very sensitive and specific markers of myocardial necrosis (troponins) and the acceptance of a 'universal definition' of AMI have certainly influenced its detection and reporting. This also explains the increase in reporting of non-ST-elevations AMI.

"The decrease in hospital mortality in patients with cardiogenic shock in the last decade is most likely due to reperfusion therapy, in particular primary angioplasty. An aggressive approach to these patient is recommended in both the US and European guidelines."


Contact: ESC Press Office
European Society of Cardiology

Related medicine news :

1. Explaining chemotherapy-associated nausea
2. ADA Calls for Scientifically Accurate Patient Brochure Explaining Filling Choices
3. Health Strategies & Solutions Diagnoses Trends and Implications for Healthcare Industry in 2009 and Beyond
4. Exclusive AARP Bulletin Poll Reveals New Trends in Multigenerational Housing
5. Frost & Sullivan Helps You Know Your End-Market: Medical Trends Impacting the Chemicals and Materials Markets
6. Your Chemist Shop Responds to Online Shopping Trends
7. Lumension Security Webinar Focuses on Security Mega Trends and Emerging Threats in 2009
8. TransMedia Group Retained by Renowned Plastic Surgeon Dr. Jeffrey Lagrasso to Share Beauty Trends, Warnings and Medical Perspective Previously Limited to the Rich and Famous
9. The Obama Effect: New Job Trends to Watch in 2009
10. Strike It Healthy Family Fits Trends for Coming Year
11. Physician Staffing Trends and Hospitalist Jobs Fuel Growth at Locum Leaders
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... Intellitec Solutions announced today that ... (MSDSLUG). Recognized as Microsoft’s official group for end users of Dynamics SL ERP ... partners, industry experts and representatives. Intellitec Solutions’ membership status demonstrates their ongoing commitment ...
(Date:11/27/2015)... ... November 27, 2015 , ... CBD College is proud to announce ... (CAAHEP) awarded accreditation to its Diagnostic Medical Sonography program. CBD College is honored to ... of twelve colleges and universities in the state of California make the cut. CBD ...
(Date:11/27/2015)... ... November 27, 2015 , ... Indosoft Inc., ... the incorporation of Asterisk 11 LTS (Long Term Support) into its Q-Suite 5.10 ... brings Q-Suite 5.10 up-to-date with a version of Asterisk that will receive not ...
(Date:11/26/2015)... Ashburn, VA (PRWEB) , ... November 26, 2015 ... ... Planners, an American Express Travel Representative. As a franchise owner, Somu now offers ... range of cruise, destination wedding packages, private cruise sales, as well as, cabin ...
(Date:11/26/2015)... ... November 26, 2015 , ... WorldCare International, Inc., the first ... annual Employee Benefits Conference. The Employee Benefits Conference was hosted by the International ... November 11th, 2015. The conference was held at the Hawaii Convention Center in ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... Nov. 25, 2015  Linden Care, LLC, a retail ... outcomes for patients suffering from chronic pain, said today ... Temporary Restraining Order (TRO) enjoining Express Scripts from unilaterally ... --> --> The ... its legal options. --> ...
(Date:11/25/2015)... Nov. 25, 2015 On Tuesday, November ... bellwether trial against Wright Medical Technology, Inc. for ... Conserve metal-on-metal hip implant device, awarded $11 million ... two week trial and three days of deliberations, ... device was defectively designed and unreasonably dangerous, and ...
(Date:11/25/2015)... , Nov. 25, 2015  Henry Schein, Inc., the ... to office-based dental, medical and animal health practitioners, will ... the Henry Schein ConnectDental® Pavilion , which brings ... of open solutions designed to help any practice or ... here for a schedule of experts appearing at ...
Breaking Medicine Technology: