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Fourteen-year (1987 to 2000) trends in the attack rates of, therapy for, and mortality from non-ST-elevation acute coronary syndromes in four United States communities.

TitleFourteen-year (1987 to 2000) trends in the attack rates of, therapy for, and mortality from non-ST-elevation acute coronary syndromes in four United States communities.
Publication TypeJournal Article
Year of Publication2005
AuthorsWatkins S, Thiemann D, Coresh J, Powe N, Folsom AR, Rosamond W
JournalAm J Cardiol
Volume96
Issue10
Pagination1349-55
Date Published2005 Nov 15
ISSN0002-9149
KeywordsAdrenergic beta-Antagonists, Adult, Aged, Aspirin, Coronary Angiography, Coronary Care Units, Coronary Disease, Electrocardiography, Female, Fibrinolytic Agents, Hospital Mortality, Humans, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction, Myocardial Revascularization, Patient Admission, Population Surveillance, Syndrome, Time Factors, Treatment Outcome, United States
Abstract

During the past 2 decades, randomized trials have proved the efficacy of several treatments for non-ST-elevation acute coronary syndromes (NSTE-ACSs), including aspirin, beta blockers, and coronary revascularization. However, the cumulative effectiveness of these evolving therapies in actual clinical practice remains unknown. The Atherosclerosis Risk In Communities (ARIC) surveillance study uses rigorous prospective community surveillance to monitor the epidemiology of coronary heart disease among subjects who are 35 to 74 years of age and reside in 4 United States communities, with a population totaling 370,000 subjects. We identified 6,379 ARIC surveillance patients who were hospitalized with NSTE-ACS (defined as cardiac chest pain and ST depression or T-wave inversion on the presenting electrocardiogram) between 1987 and 2000 and then analyzed 30-day and 1-year mortalities by calendar year of admission. Using logistic regression, 30-day mortality was modeled first using predictor variables of the calendar year, ARIC community, and indicators of severity and co-morbidity and then by adding variables for treatment with aspirin, beta blockers, and coronary revascularization to this model. Crude 30-day mortality decreased from 8.6% in 1988 to 3.6% in 2000 (p for trend

DOI10.1016/j.amjcard.2005.07.037
Alternate JournalAm J Cardiol
PubMed ID16275176
Grant ListN01 HC 55015 / HC / NHLBI NIH HHS / United States
N01 HC 55016 / HC / NHLBI NIH HHS / United States
N01 HC 55018 / HC / NHLBI NIH HHS / United States
N01 HC 55019 / HC / NHLBI NIH HHS / United States
N01 HC 55020 / HC / NHLBI NIH HHS / United States
N01 HC 55021 / HC / NHLBI NIH HHS / United States
N01 HC 55022 / HC / NHLBI NIH HHS / United States
T32 HL 07024 / HL / NHLBI NIH HHS / United States