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dc.contributor.authorAndersen, Karl
dc.contributor.authorJohannesdottir, Bergros Kristin
dc.contributor.authorKristjansson, Jon M
dc.contributor.authorGudnason, Thorarinn
dc.date.accessioned2011-04-26T11:23:32Z
dc.date.available2011-04-26T11:23:32Z
dc.date.issued2011-02
dc.date.submitted2011-04-26
dc.identifier.citationActa Cardiol. 2011, 66(1):39-45en
dc.identifier.issn0001-5385
dc.identifier.issn10.2143/AC.66.1.2064965
dc.identifier.pmid21446379
dc.identifier.urihttp://hdl.handle.net/2336/128653
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: Treatment of ST-elevation myocardial infarction (STEMI) has changed significantly over the past two decades. We investigated the effect of these changes on one-year mortality. METHODS AND RESULTS: All hospital admissions for STEMI in Reykjavik, Iceland, during the calendar years of 1986, 1996 and 2006 were studied. One-year mortality was related to changes in the use of reperfusion strategies and medication at hospital discharge. One-year mortality decreased from 26.3% in 1986 and 19.7% in 1996 to 12.9% in 2006 (P= 0.001). Cox proportional hazard analysis showed that aspirin (HR 0.29), the use of reperfusion therapy (HR 0.51) and beta-blockers at hospital discharge (HR 0.53) were the strongest factors to explain the mortality reduction while the use of diuretics (HR 1.42) and age (HR 1.06) were related to increased one-year mortality. CONCLUSIONS: The reduction in one-year mortality after myocardial infarction during the last two decades is explained by improved medical management with aspirin, beta-blockers and aggressive reperfusion therapy. Diuretic therapy, reflecting congestive heart failure, and increased age have negative effects on survival.
dc.language.isoenen
dc.publisherActa Medica Belgicaen
dc.relation.urlhttp://poj.peeters-leuven.be/content.php?url=article&id=2064965&journal_code=ACen
dc.subject.meshAgeden
dc.subject.meshFemaleen
dc.subject.meshHospital Mortalityen
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMyocardial Infarctionen
dc.subject.meshMyocardial Reperfusionen
dc.subject.meshPrognosisen
dc.subject.meshProportional Hazards Modelsen
dc.subject.meshRisk Factorsen
dc.titleDecreasing case fatality in myocardial infarction is explained by improved medical treatmenten
dc.typeArticleen
dc.contributor.departmentUniversity of Iceland, Faculty of Medicine, Reykjavik, Iceland. andersen@lsh.isen
dc.identifier.journalActa cardiologicaen
html.description.abstractOBJECTIVE: Treatment of ST-elevation myocardial infarction (STEMI) has changed significantly over the past two decades. We investigated the effect of these changes on one-year mortality. METHODS AND RESULTS: All hospital admissions for STEMI in Reykjavik, Iceland, during the calendar years of 1986, 1996 and 2006 were studied. One-year mortality was related to changes in the use of reperfusion strategies and medication at hospital discharge. One-year mortality decreased from 26.3% in 1986 and 19.7% in 1996 to 12.9% in 2006 (P= 0.001). Cox proportional hazard analysis showed that aspirin (HR 0.29), the use of reperfusion therapy (HR 0.51) and beta-blockers at hospital discharge (HR 0.53) were the strongest factors to explain the mortality reduction while the use of diuretics (HR 1.42) and age (HR 1.06) were related to increased one-year mortality. CONCLUSIONS: The reduction in one-year mortality after myocardial infarction during the last two decades is explained by improved medical management with aspirin, beta-blockers and aggressive reperfusion therapy. Diuretic therapy, reflecting congestive heart failure, and increased age have negative effects on survival.


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