Navigation Links
Explaining trends in heart attack
Date:3/11/2009

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
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:1/18/2017)... Agoura Hills, CA (PRWEB) , ... January 18, ... ... risk of dental problems ranging from gum disease to enamel erosion, and those ... from the Massachusetts Department of Public Health, many pregnant women are failing to ...
(Date:1/17/2017)... ... , ... January is National Stalking Awareness Month (NSAM), now in its fourteenth year, ... commit the crime of stalking, a very real danger to many in our community. ... stalking and other crimes. , “Stalking: know it. Name it. Stop it.”—so reads the theme ...
(Date:1/17/2017)... ... January 17, 2017 , ... Gym Source, America’s leading retailer of premium ... South Dixie Hwy in Miami, FL. , “We are elated to be opening this ... in-store concept is designed to give clients a seamless and motivating shopping experience.” , ...
(Date:1/17/2017)... Chicago, Illinois (PRWEB) , ... January 17, 2017 , ... ... Antonio Breast Cancer Symposium (SABCS) or those who desire a more intimate review and ... Antonio: Breast Cancer – Bench to Bedside—is being offered by Imedex on February 4, ...
(Date:1/17/2017)... AZ (PRWEB) , ... January 17, 2017 , ... ... and improved supplement, Healthful-Flex. , The company, owned and operated by Ed ... public at a reasonable price with the highest level of customer service. Healthful ...
Breaking Medicine News(10 mins):
(Date:1/18/2017)... 18, 2017  Tarix Orphan LLC today announced that ... Rare Pediatric Disease (RPD) designation for the company,s drug ... Bullosa (RDEB), a rare genetic skin disorder. There are ... limited to supportive care. "The RPD designation ... previously granted by the FDA in this indication," said ...
(Date:1/18/2017)... January 18, 2017 ML ... plans to publish an online presentation tomorrow, January ... sales forecast for 2017. Management reports that the ... record sales performance from its existing operations, and ... entry into the Cannabis sector through a ...
(Date:1/18/2017)...  Robust competition in the private marketplace is ... prices, according to a new study by ... the first to examine the share of prescription medicine ... managers (PBMs), health plans and other stakeholders in the ... first to show what happens when the list price ...
Breaking Medicine Technology: