International Journal of Epidemiology, Vol 18, S223-S227, Copyright © 1989 by International Epidemiological Association
B Pitt
There has been a gradual decrease in hospital mortality rate following
myocardial infarction (MI) since 1950, possibly due to improved therapy.
For a valid comparison of mortality rates in various countries, it will,
however, be necessary to know the characteristics of the individual patient
populations. Factors such as age, time of admission to the CCU, use of
thrombolytic agents, patency of the infarct related artery, left
ventricular ejection fraction, smoking status as well as conventional risk
factors need to be assessed before a valid comparison can be made or
conclusions reached concerning trends in mortality after MI. As new and
effective therapy for reducing mortality in patients with infarcts are
introduced such as Beta blockers, thrombolysis, aspirin, and converting
enzyme inhibitors one should be cautious in drawing conclusions as to
trends in mortality from the results of clinical trials of these agents
until one has a clear understanding of the risk factors of the population
studied. Without this information, we may be no closer to an understanding
of the cause of changing trends in mortality over the next decade than to
understanding the trends over the last two decades.
ARTICLES
Therapy for myocardial infarction: effect on trends in coronary disease mortality
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0366.
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