OBJECTIVES: The objectives of our community-wide investigation were to describe multidecade-long trends (1986-2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI). METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005. RESULTS: Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during hospitalization for AMI increased moderately in the 1990s, remained stable thereafter, and declined to being performed in 3.8% of hospitalized patients in 2005. The use of thrombolytic therapy increased between 1986 and 1995 (9.3-25.2%) and decreased markedly thereafter through 2005 (<1%). Demographic and clinical characteristics of several patients were associated with the receipt of these treatment regimens. CONCLUSION: The results of this study in residents of a large Central New England community suggest an increasingly invasive approach to the management of patients hospitalized with AMI.
OBJECTIVES: The objectives of our community-wide investigation were to describe multidecade-long trends (1986-2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI). METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005. RESULTS: Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during hospitalization for AMI increased moderately in the 1990s, remained stable thereafter, and declined to being performed in 3.8% of hospitalized patients in 2005. The use of thrombolytic therapy increased between 1986 and 1995 (9.3-25.2%) and decreased markedly thereafter through 2005 (<1%). Demographic and clinical characteristics of several patients were associated with the receipt of these treatment regimens. CONCLUSION: The results of this study in residents of a large Central New England community suggest an increasingly invasive approach to the management of patients hospitalized with AMI.
Authors: Menko-Jan de Boer; Jan-Paul Ottervanger; Arnoud W J van 't Hof; Jan C A Hoorntje; Harry Suryapranata; Felix Zijlstra Journal: J Am Coll Cardiol Date: 2002-06-05 Impact factor: 24.094
Authors: Robert J Goldberg; Frederick A Spencer; Joseph Okolo; Darleen Lessard; Jorge Yarzebski; Joel M Gore Journal: J Thromb Thrombolysis Date: 2007-06 Impact factor: 2.300
Authors: W J Rogers; J G Canto; C T Lambrew; A J Tiefenbrunn; B Kinkaid; D A Shoultz; P D Frederick; N Every Journal: J Am Coll Cardiol Date: 2000-12 Impact factor: 24.094
Authors: Hua Yang; Min Pu; David Rodriguez; Donald Underwood; Brian P Griffin; Vidyasagar Kalahasti; James D Thomas; Richard C Brunken Journal: J Am Coll Cardiol Date: 2004-02-18 Impact factor: 24.094
Authors: Essa Hariri; Mayra Tisminetzky; Darleen Lessard; Jorge Yarzebski; Joel Gore; Robert Goldberg Journal: Am J Med Date: 2018-05-04 Impact factor: 4.965
Authors: David D McManus; Stephen M Piacentine; Darleen Lessard; Joel M Gore; Jorge Yarzebski; Frederick A Spencer; Robert J Goldberg Journal: Am J Cardiol Date: 2011-05-31 Impact factor: 2.778