title: Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI.
abstract: BACKGROUND
  despite the widespread use of electrocardiographic changes to characterize patients presenting with acute myocardial infarction, little is known about recent trends in the incidence rates, treatment, and outcomes of patients admitted for acute myocardial infarction further classified according to the presence of ST-segment elevation. The objectives of this population-based study were to examine recent trends in the incidence and death rates associated with the 2 major types of acute myocardial infarction in residents of a large central Massachusetts metropolitan area.
  
  
  METHODS
  We reviewed the medical records of 5383 residents of the Worcester (MA) metropolitan area hospitalized for either ST-segment elevation acute myocardial infarction (STEMI) or non-ST-segment acute myocardial infarction (NSTEMI) between 1997 and 2005 at 11 greater Worcester medical centers.
  
  
  RESULTS
  the incidence rates (per 100,000) of STEMI decreased appreciably (121 to 77), whereas the incidence rates of NSTEMI increased slightly (126 to 132) between 1997 and 2005. Although in-hospital and 30-day case-fatality rates remained stable in both groups, 1-year postdischarge death rates decreased between 1997 and 2005 for patients with STEMI and NSTEMI.
  
  
  CONCLUSIONS
  the results of this study demonstrate recent decreases in the magnitude of STEMI, slight increases in the incidence rates of NSTEMI, and decreases in long-term mortality in patients with STEMI and NSTEMI. Our findings suggest that acute myocardial infarction prevention and treatment efforts have resulted in favorable decreases in the frequency of STEMI and death rates from the major types of acute myocardial infarction.
authors.affiliation: Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.forename: Joel
authors.initials: J
authors.lastname: Gore
authors.forename: Jorge
authors.initials: J
authors.lastname: Yarzebski
authors.forename: Frederick
authors.initials: F
authors.lastname: Spencer
authors.forename: Darleen
authors.initials: D
authors.lastname: Lessard
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy