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U.S. Heart Attacks Becoming Less Severe
Date:1/19/2009

Better control of blood pressure, other factors may be boosting survival, experts say

MONDAY, Jan. 19 (HealthDay News) -- First-time heart attacks in the United States aren't as deadly now as they have been in past decades, a long-running study finds.

"We know that deaths from heart disease are going down," said Dr. Merle Meyerson, director of the cardiovascular disease prevention program at Columbia University's St. Luke's-Roosevelt Hospital, and lead author of a report in the Jan. 20 issue of Circulation. "One reason why is that heart attacks are less severe. People are not coming in with these massive heart attacks that are killing them."

The study, with data on more than 10,000 first heart attacks that occurred in four widely separated U.S. areas, found only a marginal decrease in the heart attack death rate -- from 5.3 percent in 1987 to 3.8 percent in 2002. That is of only "borderline statistical significance," Meyerson said.

But analysis of 20 indicators of severity -- such as the damage-indicating changes seen in electrocardiograms, or biomarker molecules released by damaged heart tissue -- show a clear trend toward lowered severity, she said.

For example, heart attacks with elevations in the ST-designated portion of the ECG, an indicator of severe damage, were seen in 27.7 percent of attacks in 1987 and 20.9 percent in 2002, an average reduction of 1.9 percent per year.

The percentage of cases of cardiogenic shock, in which the heart is so damaged that it cannot pump blood to the body, decreased by 5.7 percent per year, while the percentage of cases with abnormal biomarkers such as creatine kinase or troponin decreased by a modest, but statistically significant, 0.7 percent a year.

The finding comes from the ongoing Atherosclerosis Risk in Communities Study, done in North Carolina, Maryland, Minnesota and Mississippi. It includes rural, city and suburban areas, so the f
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