Recent decline in hospital mortality among patients with acute myocardial infarction
Takahiro Hayashi1, Masaru Miyataka, Akio Kimura
1Department of Cardiology, Kinki University School of Medicine, Osaka 589-8511, Japan.
Insights
Hospital mortality for acute myocardial infarction (AMI) has decreased, particularly for patients admitted within 6 hours. However, non-cardiac deaths remain a concern, indicating a need for improved general patient care.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute myocardial infarction (AMI) remains a significant cause of mortality.
- Hospital mortality trends require analysis to identify areas for improvement in patient care.
Purpose of the Study:
- To analyze trends in hospital mortality for acute myocardial infarction patients.
- To identify factors contributing to improved outcomes and areas needing further attention.
Main Methods:
- Retrospective analysis of 1,247 acute myocardial infarction patients admitted between 1975 and 2001.
- Evaluation of changes in coronary artery stenosis, cardiac death rates, and non-cardiac death rates over time.
Main Results:
- A significant decrease in cardiac death rates from 17.1% to 7.7% was observed between 1975-1982 and 1998-2001.
- Outcomes improved significantly for patients admitted within 6 hours of infarction onset.
- Deaths due to cardiac rupture decreased significantly, while non-cardiac death rates remained unchanged.
Conclusions:
- Cardiac mortality from acute myocardial infarction has substantially decreased.
- Early admission (within 6 hours) is crucial for patients to benefit from improved treatments.
- Reducing non-cardiac mortality requires enhanced general patient care strategies.
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.
Methods And 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.
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