What is the clinical evidence from this study?

Study design: Observational. Population: Acute myocardial infarction (n=1494). Intervention: Universal 2007 definition of AMI vs. WHO 1979 definition of AMI. Primary outcome: Number of definite AMI events (p=< 0.001).

June 3, 2013European Journal of Preventive Cardiology

Implications of changing definitions of myocardial infarction on number of events and all-cause mortality: the WHO 1979, ESC/ACC 2000, AHA 2003, and Universal 2007 definitions revisited

Q: What are the key findings of this study?

Applying the Universal 2007 definition of AMI increased the number of diagnosed events by 31% compared to the WHO 1979 definition (743 vs 566; p<0.001), with 8-year mortality of 43% vs 40%.

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Key result

Applying the Universal 2007 definition of AMI increased the number of diagnosed events by 31% compared to the WHO 1979 definition (743 vs 566; p<0.001), with 8-year mortality of 43% vs 40%.

Why the study?

Does the application of newer AMI definitions change the number of diagnosed events and the associated all-cause mortality compared to the WHO 1979 definition in hospitalized patients?

Population

1,494 patients admitted to Haukeland University Hospital in Norway from March 2002 to February 2003…

Comparison

Application of newer acute myocardial infarction… vs WHO 1979 definition of acute myocardial…

Design

Cohort

Follow-up

up to 8 years

Authors

JLJørund LangørgenHaukeland University Hospital MEMarta EbbingHaukeland University Hospital JIJannicke IglandWestern Norway University of Applied Sciences

Discussion

Member takes

Implication

Newer AMI definitions may inflate incidence and mortality estimates; leaves open how to standardize trends across diagnostic eras.

Study Design

Type

Observational (n=1,494)

Multicenter

Structured PICO

Does the application of newer AMI definitions change the number of diagnosed events and the associated all-cause mortality compared to the WHO 1979 definition in hospitalized patients?

Population

1,494 patients admitted to a Norwegian hospital with a discharge diagnosis of AMI or elevated cardiac troponin I level, followed for up to 8 years.

Exposure

Application of newer acute myocardial infarction definitions (ESC/ACC 2000, AHA 2003, and Universal 2007).

Comparator

WHO 1979 definition of acute myocardial infarction.

Outcome

Number of acute myocardial infarction events and all-cause mortality at 28 days, 1 year, 5 years, and 8 years.hard clinical

Main Result

Absolute Event Rate: 49.7% vs 37.9%

p-value: p=< 0.001

The transition to newer, troponin-based definitions of myocardial infarction significantly increases the number of diagnosed events and modestly increases the observed mortality rate of the diagnosed cohort.

Cite This Study

Langørgen et al. (2013) conducted an observational in Acute myocardial infarction (n=1,494). Universal 2007 definition of AMI vs. WHO 1979 definition of AMI was evaluated on Number of definite AMI events (p=< 0.001). Applying the Universal 2007 definition of AMI increased the number of diagnosed events by 31% compared to the WHO 1979 definition (743 vs 566; p<0.001), with 8-year mortality of 43% vs 40%.

synapsesocial.com/papers/6a966e09a43071aed1f69fa2 https://doi.org/10.1177/2047487313493056

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Implications of changing definitions of myocardial infarction on number of events and all-cause mortality: the WHO 1979, ESC/ACC 2000, AHA 2003, and Universal 2007 definitions revisited

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Implications of changing definitions of myocardial infarction on number of events and all-cause mortality: the WHO 1979, ESC/ACC 2000, AHA 2003, and Universal 2007 definitions revisited

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider