OBJECTIVE: To assess the impact of incidence, recurrence, and case fatality rates for myocardial infarction on coronary heart disease mortality in southwestern France between 1985 and 1993. DESIGN: Toulouse-MONICA myocardial infarction register. SETTINGS AND PATIENTS: All subjects aged 35 to 64 years living in the French department of Haute-Garonne. INTERVENTIONS: All coronary artery disease events between 1985 and 1993. MAIN OUTCOME MEASURES: 7210 events collected by the register between 1985 and 1993. RESULTS: In men, adjusted attack, total, and out of hospital mortality decreased by 2% (95% confidence interval (CI), -3.8% to -0.1%), 6.2% (95% CI -8.4% to -4.0%), and 4.2% (95% CI -7.0% to -1.5%) a year, respectively (p < 0.05). Incidence and recurrence rates decreased by 2% (95% CI -4.1% to -0.1%, p < 0.05) and 1.9% (95% CI -5.9% to 2.2%) a year (NS). In women, attack, total, and out of hospital mortality decreased by 1.7% (95% CI -5.2% to 1.8%), 4.8% (95% CI -9.6% to 0. 1%), and 2.6% (95% CI -9.4% to 4.1%) a year, respectively; incidence decreased by 2% (95% CI -6.5% to 2.5%) and recurrence increased by 1. 4% (95% CI -9.8% to 12.6%) a year (all NS). In men, total, incident, and recurrent 28 day case fatality decreased by 3.8% (95% CI -4.8% to -2.8%), 3.2% (95% CI -4.1% to -2.3%), and 6.4% (95% CI -9.5% to -3.3%) a year, respectively (p < 0.05). For women, the corresponding decreases were 3.3% (95% CI -6.1% to -0.6%), 3.3% (95% CI -13.2% to 6.6%), and 11.7% (95% CI -24.6% to 1.3%) a year, but only the decrease in total 28 day case fatality reached significance. In both sexes, the reduction in case fatality contributed nearly 70% of the decrease in myocardial infarction mortality. CONCLUSIONS: In southwestern France, the decrease in myocardial infarction mortality mainly reflects improvements in acute management rather than prevention.
OBJECTIVE: To assess the impact of incidence, recurrence, and case fatality rates for myocardial infarction on coronary heart disease mortality in southwestern France between 1985 and 1993. DESIGN: Toulouse-MONICA myocardial infarction register. SETTINGS AND PATIENTS: All subjects aged 35 to 64 years living in the French department of Haute-Garonne. INTERVENTIONS: All coronary artery disease events between 1985 and 1993. MAIN OUTCOME MEASURES: 7210 events collected by the register between 1985 and 1993. RESULTS: In men, adjusted attack, total, and out of hospital mortality decreased by 2% (95% confidence interval (CI), -3.8% to -0.1%), 6.2% (95% CI -8.4% to -4.0%), and 4.2% (95% CI -7.0% to -1.5%) a year, respectively (p < 0.05). Incidence and recurrence rates decreased by 2% (95% CI -4.1% to -0.1%, p < 0.05) and 1.9% (95% CI -5.9% to 2.2%) a year (NS). In women, attack, total, and out of hospital mortality decreased by 1.7% (95% CI -5.2% to 1.8%), 4.8% (95% CI -9.6% to 0. 1%), and 2.6% (95% CI -9.4% to 4.1%) a year, respectively; incidence decreased by 2% (95% CI -6.5% to 2.5%) and recurrence increased by 1. 4% (95% CI -9.8% to 12.6%) a year (all NS). In men, total, incident, and recurrent 28 day case fatality decreased by 3.8% (95% CI -4.8% to -2.8%), 3.2% (95% CI -4.1% to -2.3%), and 6.4% (95% CI -9.5% to -3.3%) a year, respectively (p < 0.05). For women, the corresponding decreases were 3.3% (95% CI -6.1% to -0.6%), 3.3% (95% CI -13.2% to 6.6%), and 11.7% (95% CI -24.6% to 1.3%) a year, but only the decrease in total 28 day case fatality reached significance. In both sexes, the reduction in case fatality contributed nearly 70% of the decrease in myocardial infarction mortality. CONCLUSIONS: In southwestern France, the decrease in myocardial infarction mortality mainly reflects improvements in acute management rather than prevention.
Authors: N Sigfusson; H Sigvaldason; L Steingrimsdottir; I I Gudmundsdottir; I Stefansdottir; T Thorsteinsson; G Sigurdsson Journal: BMJ Date: 1991-06-08
Authors: R Malacrida; M Genoni; A P Maggioni; V Spataro; S Parish; A Palmer; R Collins; T Moccetti Journal: N Engl J Med Date: 1998-01-01 Impact factor: 91.245
Authors: T Lang; P Ducimetière; D Arveiler; P Amouyel; J Ferrières; J B Ruidavets; M Montaye; B Haas; A Bingham Journal: J Epidemiol Community Health Date: 1998-10 Impact factor: 3.710
Authors: W D Rosamond; L E Chambless; A R Folsom; L S Cooper; D E Conwill; L Clegg; C H Wang; G Heiss Journal: N Engl J Med Date: 1998-09-24 Impact factor: 91.245
Authors: P Buch; S Rasmussen; G H Gislason; J N Rasmussen; L Køber; N Gadsbøll; S Stender; M Madsen; C Torp-Pedersen; S Z Abildstrom Journal: Heart Date: 2006-08-29 Impact factor: 5.994