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January 26, 2009BMJOpen Access

Long term survival after evidence based treatment of acute myocardial infarction and revascularisation: follow-up of population based Perth MONICA cohort, 1984-2005

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Why the study?

Does admission in a later era with higher use of evidence-based treatments and revascularisation improve long-term survival in 28-day survivors of acute myocardial infarction compared to an earlier era?

Population

4,451 consecutive patients alive 28 days after a definite acute myocardial infarction admitted to hospital…

Comparison

Admission during the 1991-1993 era. vs Admission during the 1984-1987 era.

Design

Cohort

Follow-up

12 years

Authors

TBT. BriffaThe University of Western AustraliaSHSiobhan HicklingThe University of Western AustraliaMKMatthew KnuimanPreventive Cardiology

Discussion

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Overview

Mortality gains in later-era post-MI survivors were explained by treatments and revascularisation; extends observational evidence but leaves causality open.

Structured PICO

Does admission in a later era with higher use of evidence-based treatments and revascularisation improve long-term survival in 28-day survivors of acute myocardial infarction compared to an earlier era?

P
Population
4,451 consecutive patients alive 28 days after a definite acute myocardial infarction (WHO MONICA criteria) admitted to hospital during 1984-1987, 1988-1990, and 1991-1993 in Perth, Australia.
I
Intervention
Admission during the 1991-1993 era (associated with progressive use of evidence-based medical treatments in hospital and coronary revascularisation procedures within 12 months).
C
Comparator
Admission during the 1984-1987 era.
O
Outcome
All cause mortality identified from official mortality records and hospital morbidity data over 12 years.hard clinical

Progressive adoption of evidence-based medical treatments and coronary revascularization is associated with significant improvements in 12-year survival following acute myocardial infarction.

Cite This Study

Briffa et al. (2009) studied this question.

synapsesocial.com/papers/6a7684fbb8e2d31284295bafhttps://doi.org/10.1136/bmj.b36
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents.1994 · 2,287 citations
  2. 2Long term relative survival after surgery for abdominal aortic aneurysm in Western Australia: population based study1998 · 117 citations
  3. 3Secondary prevention of vascular disease by prolonged antiplatelet treatment1988 · 1,051 citations
  4. 4Trends in Acute Coronary Heart Disease Mortality, Morbidity, and Medical Care From 1985 Through 19972001 · 345 citations
  5. 5Recent Trends in Acute Coronary Heart Disease — Mortality, Morbidity, Medical Care, and Risk Factors1996 · 702 citations