Clinical research studyRecent Trends in the Incidence, Treatment, and Outcomes of Patients with STEMI and NSTEMI
Section snippets
Methods
The Worcester Heart Attack Study is an ongoing population-based investigation examining long-term trends in the incidence rates, in-hospital, and post-discharge case-fatality rates (CFRs) of greater Worcester (MA) (2000 census = 478,000) residents hospitalized with acute myocardial infarction at all metropolitan Worcester medical centers. In brief, the medical records of greater Worcester residents admitted to all 11 hospitals throughout central Massachusetts with a discharge diagnosis of acute
Characteristics of Study Patients
A total of 5383 greater Worcester residents were hospitalized with confirmed acute myocardial infarction during the 5 biennial study years (Table 1). Individuals hospitalized for STEMI were more likely to be younger, male, and were less likely to have a prior history of several comorbidities in comparison with patients with NSTEMI. Patients with STEMI were also more likely to undergo cardiac catheterization or PCI and to be treated with aspirin, beta-blockers, and either an
Trends in Hospitalization Rates
Hospitalization rates for acute myocardial infarction have remained largely stable or slightly increased over time in the US population.6, 16, 17 Our results provide relatively recent insights into these trends by suggesting that recent decreases in hospitalization for STEMI have been counter-balanced by slight increases in hospitalization for NSTEMI.
Improved coronary risk factor awareness and treatment practices may have contributed to the decreases in the incidence of STEMI observed in the
Conclusions
The incidence rates of STEMI decreased significantly between 1997 and 2005. Incidence rates of NSTEMI increased slightly during this period, likely as a result of high-sensitivity biomarker introduction. Encouraging trends were noted in the postdischarge death rates for both STEMI and NSTEMI at 1 year, suggesting that acute myocardial infarction treatment practices have likely improved the long-term outlook for all patients hospitalized with acute myocardial infarction. Increased attention
Acknowledgments
We wish to acknowledge all persons involved in the review of data for this project as well as to our collaborators at all greater Worcester hospitals.
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Funding: National Institutes of Health (RO1 HL35434).
Conflict of Interest: There are no conflicts of interest to report for any of the authors.
Authorship: All authors had access to the data and had a role in writing this manuscript.