Mortality trends in men and women with acute myocardial infarction in coronary care units in Israel. A comparison
S Gottlieb1, U Goldbourt, V Boyko
1The Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
European Heart Journal
|February 2, 2000
Summary
Mortality from acute myocardial infarction (AMI) significantly decreased in both men and women between the pre-reperfusion and reperfusion eras. This improvement in AMI outcomes highlights the impact of modern therapeutic interventions on patient prognosis.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute myocardial infarction (AMI) management and outcomes have evolved significantly.
- The transition from pre-reperfusion to reperfusion eras marked a paradigm shift in cardiac care.
Purpose of the Study:
- To evaluate trends in AMI management and patient outcomes in Israel.
- To compare outcomes between men and women in the pre-reperfusion and reperfusion eras.
Main Methods:
- Analysis of two patient cohorts from Israel: 1981-1983 (pre-reperfusion) and 1992-1994 (reperfusion).
- Comparison of in-hospital management, 30-day, and 1-year mortality rates between eras and sexes.
- Assessment of the impact of reperfusion therapies (thrombolysis, angioplasty, etc.) on outcomes.
Main Results:
- Patients in the reperfusion era received more guideline-directed medical therapies (aspirin, ACE inhibitors, beta-blockers).
- Reperfusion procedures (thrombolysis, angioplasty, bypass grafting) were introduced in the later era.
- Both 30-day and 1-year mortality rates declined significantly for men and women, with similar reductions observed in both sexes.
Conclusions:
- Prognosis for acute myocardial infarction improved substantially for both men and women.
- The implementation of new therapeutic modalities in clinical practice played a crucial role in improving patient outcomes.
- Despite improvements, women continued to experience higher mortality rates than men.
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