Two-year mortality after acute myocardial infarction decreased from 36% in 1984 to 25% in 1991, coinciding with the introduction of new treatments.
Cohort (n=3,187)
No
Does the introduction of intravenous beta-blockers, nitroglycerin infusion, aspirin, and thrombolytics reduce 2-year mortality in patients hospitalized with an acute myocardial infarction?
There was a substantial decrease in 2-year mortality after acute myocardial infarction from 1984 to 1991, coinciding with the introduction of new medical therapies.
Absolute Event Rate: 25% vs 36%
AIMS: We set out to examine whether long term prognosis in terms of 2-year mortality after myocardial infarction has improved after the introduction of intravenous beta-blockers, nitroglycerin infusion, aspirin and thrombolytics, in an unselected population of patients hospitalized with a myocardial infarction. METHODS AND RESULTS: We investigated retrospectively 3791 acute myocardial infarctions in 3187 Göteborg women and men (1039 women and 2148 men), who were consecutively admitted to the coronary care unit at the Ostra hospital during 1984-1991. Throughout this period, data were entered continuously into the coronary care unit database. Mortality data were collected through the Swedish cause-specific mortality register. The primary end-point was mortality within 2 years after the onset of the index infarction. Two-year mortality decreased from 36% in 1984 to 25% in 1991. In a Cox regression model (including myocardial infarctions up to 1993) year of hospitalization, age, diabetes mellitus, sex, prior myocardial infarction and indeterminable infarct location all had a significant impact on survival after myocardial infarct. Thrombolytic therapy and hypertension had no prognostic significance. CONCLUSION: Against a background of radical changes in the treatment of acute myocardial infarction during 1984-1991 we have seen decreasing in-hospital mortality as well as a substantial decrease in 2-year mortality.
Putte Abrahamsson (Thu,) conducted a cohort in acute myocardial infarction (n=3,187). Year of hospitalization (1991 vs 1984) reflecting introduction of new treatments vs. Year 1984 was evaluated on Mortality within 2 years after the onset of the index infarction. Two-year mortality after acute myocardial infarction decreased from 36% in 1984 to 25% in 1991, coinciding with the introduction of new treatments.