This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Edlavitch, S. A. Articles by Baxter, J. Search for Related Content PubMed PubMed Citation Articles by Edlavitch, S. A. Articles by Baxter, J. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Heart Attack

Circulation, Vol 83, 492-503, Copyright © 1991 by American Heart Association

ARTICLES

Secular trends in Q wave and non-Q wave acute myocardial infarction. The Minnesota Heart Survey

SA Edlavitch, R Crow, GL Burke and J Baxter
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455.

The Minnesota Heart Survey examined trends of Q wave and non-Q wave acute myocardial infarction (AMI) using a 50% random sample of all hospital discharges of patients with AMI or another acute coronary disease from 35 of 36 hospitals in 1970 and 30 of 31 hospitals in 1980 in the Minneapolis-St. Paul metropolitan area. A total of 1,901 and 1,864 potential AMI cases were abstracted in 1970 and 1980, respectively. Electrocardiograms were coded according to the Minnesota code. AMIs were validated by computerized algorithm based on chest pain, enzymes, electrocardiograms, and autopsy. This study shows that with the use of a consistent, standard diagnostic algorithm, attack rates for Q wave AMI did not change significantly between 1970 and 1980 and that attack rates for non-Q wave AMI decreased significantly during the same decade. However, when the more sensitive cardiac enzymes creatine phosphokinase and creatine phosphokinase-MB were considered, attack rates of both Q wave and non-Q wave AMIs increased. This research documents four important trends for community AMI rates that are at variance with those reported by others. There was a decline in non-Q wave AMI attack rates from 1970 to 1980; women had outcomes equal to or worse than those for men for both case-fatality and 7-year survival rates; patients with non-Q wave AMIs had worse in-hospital prognoses than those with Q wave AMIs; and 7-year survival rates were worse for Q wave AMI in 1980. These findings demonstrate the need for standard diagnostic criteria for Q wave and non-Q wave AMI if trends are to be monitored. In the future, as new trials of operative and nonoperative therapies of AMI are undertaken, these considerations will increase in importance.

This article has been cited by other articles:

				F. A. Masoudi, J. M. Foody, E. P. Havranek, Y. Wang, M. J. Radford, R. M. Allman, J. Gold, R. T. Wiblin, and H. M. Krumholz Trends in Acute Myocardial Infarction in 4 US States Between 1992 and 2001: Clinical Characteristics, Quality of Care, and Outcomes Circulation, December 19, 2006; 114(25): 2806 - 2814. [Abstract] [Full Text] [PDF]

				J. Aoki, A. T.L. Ong, A. Hoye, L. A. van Herwerden, J. E. Sousa, A. Jatene, J. J.R.M. Bonnier, J. P.M.A. Schonberger, N. Buller, R. Bonser, et al. Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial Eur. Heart J., August 1, 2005; 26(15): 1488 - 1493. [Abstract] [Full Text] [PDF]

				C. S. Fox, J. C. Evans, M. G. Larson, W. B. Kannel, and D. Levy Temporal Trends in Coronary Heart Disease Mortality and Sudden Cardiac Death From 1950 to 1999: The Framingham Heart Study Circulation, August 3, 2004; 110(5): 522 - 527. [Abstract] [Full Text] [PDF]

				J. P. Hellermann, G. S. Reeder, S. J. Jacobsen, S. A. Weston, J. M. Killian, and V. L. Roger Longitudinal Trends in the Severity of Acute Myocardial Infarction: A Population Study in Olmsted County, Minnesota Am. J. Epidemiol., August 1, 2002; 156(3): 246 - 253. [Abstract] [Full Text] [PDF]

				P.J. de Feyter, P.W. Serruys, F. Unger, R. Beyar, V. de Valk, S. Milo, R. Simon, D. Regensburger, P.A. Crean, E. McGovern, et al. Bypass Surgery Versus Stenting for the Treatment of Multivessel Disease in Patients With Unstable Angina Compared With Stable Angina Circulation, May 21, 2002; 105(20): 2367 - 2372. [Abstract] [Full Text] [PDF]

				B. P. Phibbs and F. I. Marcus Perpetuation of the myth of the Q-wave versus the non-Q-wave myocardial infarction J. Am. Coll. Cardiol., February 6, 2002; 39(3): 556 - 557. [Full Text] [PDF]

				A. Abizaid, M. A. Costa, M. Centemero, A. S. Abizaid, V. M.G. Legrand, R. V. Limet, G. Schuler, F. W. Mohr, W. Lindeboom, A. G.M.R. Sousa, et al. Clinical and Economic Impact of Diabetes Mellitus on Percutaneous and Surgical Treatment of Multivessel Coronary Disease Patients: Insights From the Arterial Revascularization Therapy Study (ARTS) Trial Circulation, July 31, 2001; 104(5): 533 - 538. [Abstract] [Full Text] [PDF]

				M. I. Furman, H. L. Dauerman, R. J. Goldberg, J. Yarzbeski, D. Lessard, and J. M. Gore Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1571 - 1580. [Abstract] [Full Text] [PDF]

				P. W. Serruys, F. Unger, J. E. Sousa, A. Jatene, H. J.R.M. Bonnier, J. P.A.M. Schonberger, N. Buller, R. Bonser, M. J.B. van den Brand, L. A. van Herwerden, et al. Comparison of Coronary-Artery Bypass Surgery and Stenting for the Treatment of Multivessel Disease N. Engl. J. Med., April 12, 2001; 344(15): 1117 - 1124. [Abstract] [Full Text] [PDF]

				U. C. Guidry, J. C. Evans, M. G. Larson, P. W. F. Wilson, J. M. Murabito, and D. Levy Temporal Trends in Event Rates After Q-Wave Myocardial Infarction : The Framingham Heart Study Circulation, November 16, 1999; 100(20): 2054 - 2059. [Abstract] [Full Text] [PDF]

				N. Brown, T. Young, D. Gray, A. M Skene, and J. R Hampton Inpatient deaths from acute myocardial infarction, 1982-92: analysis of data in the Nottingham heart attack register BMJ, July 19, 1997; 315(7101): 159 - 164. [Abstract] [Full Text]

				M. Enriquez-Sarano, E. Klodas, K. N. Garratt, K. R. Bailey, A. J. Tajik, and D. R. Holmes Secular Trends in Coronary Atherosclerosis -- Analysis in Patients with Valvular Regurgitation N. Engl. J. Med., August 1, 1996; 335(5): 316 - 322. [Abstract] [Full Text] [PDF]

				S. Capewell The continuing rise in emergency admissions BMJ, April 20, 1996; 312(7037): 991 - 992. [Full Text]