title: Recent decline in hospital mortality among patients with acute myocardial infarction.
abstract: 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.
authors.affiliation: Department of Cardiology, Kinki University School of Medicine, Osaka 589-8511, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayashi
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyataka
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Kurooka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yabushita
authors.forename: Takashi
authors.initials: T
authors.lastname: Kiyoshima
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirano
authors.forename: Kinji
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: 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*