Recent decline in hospital mortality among patients with acute myocardial infarction.
BACKGROUND
Many patients with acute myocardial infarction will still die after admission. Recent trends in hospital mortality were analyzed to identify aspects that need improvement.


RESULTS
A total of 1,247 patients admitted to Kinki University School of Medicine within 24 h of the onset of infarction were analyzed between 1975 and 2001. The percentage of patients discharged with 100% occlusion decreased gradually from 31.3% during 1975-1982 to 2.1% during 1998-2001, while those with 50% stenosis or less gradually increased from 12.5% to 82.5% during the same period (trends: p < 0.01). The cardiac death rate was 17.1% in 1975-1982, and 7.7% in 1998-2001, showing a significant decrease with time (p < 0.01). This decrease was particularly marked among those admitted within 6 h of the onset of infarction. Death due to cardiac rupture decreased significantly with time (p < 0.001). In contrast, the non-cardiac death rate, amounting to 2.2% on average, did not decline.


CONCLUSIONS
Cardiac deaths due to acute myocardial infarction have decreased markedly of late. However, patients must be admitted within 6 h of the onset of infarction to benefit from this improvement. More effort should be made to improve the general care of patients in order to reduce the incidence of non-cardiac death.
Hayashi
Takahiro
T
Department of Cardiology, Kinki University School of Medicine, Osaka 589-8511, Japan.
Miyataka
Masaru
M
Kimura
Akio
A
Taniguchi
Mitsugu
M
Kurooka
Atsuhiro
A
Yabushita
Hiroshi
H
Kiyoshima
Takashi
T
Nakamura
Hajime
H
Hirano
Yutaka
Y
Ishikawa
Kinji
K
D000368:Aged; D002423:Cause of Death; D023921:Coronary Stenosis; D003643:Death; D005260:Female; D006342:Heart Rupture, Post-Infarction; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*