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(Circulation. 1999;99:1104-1108.)
© 1999 American Heart Association, Inc.

Abstracts of the 39th Annual Conference on Cardiovascular Disease Epidemiology and Prevention

Oral Presentations

1 Trends in Severity of Hospitalized Myocardial Infarction: The ARIC Study, 1987-1994.

David C. Goff, George Howard, Chin-Hua Wang, Aaron R. Folsom, Wayne D. Rosamond, Lawton S. Cooper, Lloyd E. Chambless, National Heart, Lung and Blood Institute, Bethesda, MD, University of Minnesota, Minneapolis, MN, University of North Carolina, Chapel Hill, NC, Wake Forest University School of Medicine, Winston-Salem, NC

Declining rates of CHD mortality observed in the US could be due to declining incidence of CHD, declining severity of CHD, and/or improving management of CHD. We examined trends in severity of hospitalized MI to characterize its potential contribution to this decline. Data from the community surveillance component of the ARIC Study were examined for the period 1987 through 1994 for all hospitalizations that met criteria for definite or probable incident MI (N = 4903). Hemodynamic, electrocardiographic and enzymatic indicators of severity of MI and diagnostic categories were examined. Temporal trends in these severity indicators were tested with adjustment for age, sex, race, and community (and use of thrombolytics for peak CK). No significant temporal change in the proportion having SBP < 100 mm Hg or an abnormal pulse was noted. The proportion with ST elevation on the initial ECG increased 10% per year (p<0.001), and the proportion with a diagnostic (or evolving diagnostic) ECG abnormality increased 4% per year (p<0.01); whereas, the proportion that developed a new Q-wave during the hospitalization remained unchanged. The mean peak CK declined 5% per year (p<0.001), the proportion with abnormal enzymes declined 10% per year (p<0.001), and the proportion that met criteria for definite (versus probable) . . . [Full Text of this Article]

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