The present population-based study proposes to continue the examination of temporal trends in the incidence and survival rates of acute myocardial infarction (AMI) and out of hospital deaths due to coronary heart disease (CHD) in the setting of the Worcester, MA Standard Metropolitan Statistical Area (SMSA). The objectives of this study are to examine recent (1997 and 1999) as compared to prior (1975, 1978, 1981, 1984, 1986, 1988, 1990, 1991, 1993 and 1995) time trends in the annual attack rates of AMI and out of hospital CHD deaths, recent (1997 and 1999) as well as prior (1975-1995) changes over time in the in hospital and long term survival rates of AMI, and the relationship of these incidence and survival patterns of AMI to selected demographic, clinical and medical care factors. An additional objective of this study is to examine changes over time in the therapeutic management, diagnostic evaluation, and surgical workup of patients hospitalized with AMI as well as related issues of cost. To accomplish these objectives, the proposed study will be carried out in the 13 acute general hospitals in the Worcester, MA SMSA (1990 census count = 437,000). This study will utilize and extend previous approaches used in the conduct of this study. All new (incident) and recurrent episodes of definite AMI occurring among Worcester SMSA residents during calendar years 1997 and 1999 will be identified from discharge diagnostic printouts obtained from all metropolitan Worcester hospitals. The medical records of patients from the Worcester SMSA will be individually reviewed for validation purposes according to pre-established diagnostic criteria for AMI. Abstraction of the medical records of patients satisfying the diagnostic and geographic eligibility criteria will be carried out with the standardized recording of relevant data. A review of records for additional hospitalizations and a statewide and national search of death certificates will be carried out to examine the long-term survival status of discharged hospital patients from each of the proposed study years as well as those identified previously (1975-1995) through the year 2000. Death certificates of Worcester SMSA residents will be reviewed to identify cases of out of hospital deaths due to CHD occurring in 1997 and 1999 to determine temporal trends in these incidence rates. The results of this community-wide investigation may provide important insights from a twenty-four year vantage point about the role of primary and secondary preventive and therapeutic efforts to declining CHD mortality rates as it affects the population of a large representative and stable metropolitan area.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL035434-16
Application #
6388985
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Sorlie, Paul
Project Start
1986-12-01
Project End
2001-09-29
Budget Start
2001-05-08
Budget End
2001-09-29
Support Year
16
Fiscal Year
2001
Total Cost
$173,265
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
660735098
City
Worcester
State
MA
Country
United States
Zip Code
01655
Hariri, Essa; Tisminetzky, Mayra; Lessard, Darleen et al. (2018) Twenty-Five-Year (1986-2011) Trends in the Incidence and Death Rates of Stroke Complicating Acute Myocardial Infarction. Am J Med 131:1086-1094
Tisminetzky, Mayra; Nguyen, Hoa L; Gurwitz, Jerry H et al. (2018) Magnitude and impact of multiple chronic conditions with advancing age in older adults hospitalized with acute myocardial infarction. Int J Cardiol 272:341-345
Li, Lin; Jesdale, Bill M; Hume, Anne et al. (2018) Who are they? Patients with heart failure in American skilled nursing facilities. J Cardiol 71:428-434
Li, Lin; Jesdale, Bill M; Hume, Anne et al. (2017) Pharmacotherapy Use in Older Patients With Heart Failure and Reduced Ejection Fraction After a Skilled Nursing Facility Stay. J Card Fail 23:843-851
Makam, Raghavendra P; Erskine, Nathaniel; Yarzebski, Jorge et al. (2016) Decade Long Trends (2001-2011) in Duration of Pre-Hospital Delay Among Elderly Patients Hospitalized for an Acute Myocardial Infarction. J Am Heart Assoc 5:e002664
Tisminetzky, Mayra; Goldberg, Robert; Gurwitz, Jerry H (2016) Magnitude and Impact of Multimorbidity on Clinical Outcomes in Older Adults with Cardiovascular Disease: A Literature Review. Clin Geriatr Med 32:227-46
Chen, Han-Yang; Gore, Joel M; Lapane, Kate L et al. (2016) Decade-long trends in the timeliness of receipt of a primary percutaneous coronary intervention. Clin Epidemiol 8:141-9
Awad, Hamza H; Tisminetzky, Mayra; Metry, Diana et al. (2016) Magnitude, treatment, and impact of diabetes mellitus in patients hospitalized with non-ST segment elevation myocardial infarction: A community-based study. Diab Vasc Dis Res 13:13-20
Makam, Raghavendra Charan P; Erskine, Nathaniel; McManus, David D et al. (2016) Decade-Long Trends (2001 to 2011) in the Use of Evidence-Based Medical Therapies at the Time of Hospital Discharge for Patients Surviving Acute Myocardial Infarction. Am J Cardiol 118:1792-1797
Chen, Han-Yang; Tisminetzky, Mayra; Yarzebski, Jorge et al. (2016) Decade-Long Trends in the Frequency of 90-Day Rehospitalizations After Hospital Discharge for Acute Myocardial Infarction. Am J Cardiol 117:743-8

Showing the most recent 10 out of 117 publications