Clinical Investigations: Acute Ischemic Heart DiseasePrognosis after acute myocardial infarction continues to improve in the reperfusion era in the community of Göteborg*,**,★
Section snippets
Period 1
All patients hospitalized for AMI at the 2 city hospitals (Sahlgrenska and Östra Hospitals) in Göteborg between January 1, 1990, and December 31, 1991, were aged <75 years and living in the community of Göteborg. There are no private hospitals or other hospitals in the community. There are 2 hospitals outside the community 10 and 20 kilometers from the 2 community hospitals. However, patients in the community of Göteborg were not admitted to these hospitals.
Period 2
All patients hospitalized for AMI at
Results
In all, there were 926 patients registered during period 1 and 861 during period 2. The incidence rate for AMI per 100,000 inhabitants and year was 200 for period 1 and 183 for period 2. The proportion of patients admitted to the CCU was 91% during period 1 and 96% during period 2 (P =.0002).
Discusson
During the last decade, many surveys have compared the outcome of patients with AMI before and after the introduction of thrombolysis (prethrombolytic and postthrombolytic eras).10, 13, 19 A reduction in mortality rate was observed, although it has been clearly stated that the reduced mortality rate might be attributable to factors other than the introduction of thrombolysis.2, 19
However, few studies have been from the more generalizable perspective of a total community.
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Cited by (27)
Limited prognostic value of noninvasive assessment of reperfusion by continuous vectorcardiography in an unselected cohort of patients with acute ST-elevation myocardial infarction treated with thrombolysis
2007, Journal of ElectrocardiologyCitation Excerpt :Previously, a decrease in mortality rates of myocardial infarction has been observed during 1990s.16 In a community-based study from Gothenburg in Sweden, the reported 30-day mortality in all myocardial infarction patients treated from 1990 to 1991 was 9.9% and decreased to 6.5% from 1995 to 1996.16 In the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries-III electrocardiographic substudy comparing outcomes according to ST-segment resolution at 90 and 180 minutes after administration of thrombolytic therapy, similar mortality rates to the ones noted in our study were reported.17
Prognostic Value of Midregional Pro-Adrenomedullin in Patients With Acute Myocardial Infarction. The LAMP (Leicester Acute Myocardial Infarction Peptide) Study
2007, Journal of the American College of CardiologyCardiotrophin-1 Predicts Death or Heart Failure Following Acute Myocardial Infarction
2006, Journal of Cardiac FailureCitation Excerpt :The logistic model combining the 2 markers (predicted probability) yielded an AUC of 0.84 (95% CI: 0.78–0.91, P < .001), which exceeded that of either peptide alone (Fig. 5). Reperfusion therapy has improved mortality after MI; however the outcome of patients despite this is still poor18; for this reason, risk stratification remains important and may be useful in helping to select treatment regimes in the future. A multimarker strategy has benefits in that it uses the different pathways that are involved in the development and outcome of an AMI in the hope that complementary information can be gained.19
Cardiac rehabilitation after myocardial infarction in the community
2004, Journal of the American College of CardiologyComparison of treatment and outcomes for patients with acute myocardial infarction in Minneapolis/St. Paul, Minnesota, and Göteborg, Sweden
2003, American Heart JournalCitation Excerpt :In both GB and MSP, it is apparent that the early mortality rate, including in-hospital deaths at 30 days, is remarkably low (3%–4%). It has improved in recent years.17,18 The more extensive use of proven medications and early reperfusion procedures supports this improvement.
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Supported by grants from the Swedish Heart and Lung Foundation, Stockholm, the Gothenburg Medical Society, Göteborg, and The Association of Local Authorities in Western Götaland, Sweden.
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Reprint requests: Johan Herlitz, MD, PhD, Division of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
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E-mail: [email protected]