Abstract
All patients under 60 years of age who were discharged from hospital after a first myocardial infarction between 1968 and 1977 in Göteborg were followed for a minimum of 24 months. The patients were unselected, and treatment was standardised. The patients were divided into five two yearly cohorts, and the prognostic comparability and mortality of these cohorts were assessed. There was a reduction in the two year mortality rate after discharge during the 10 year period. Small baseline differences between the cohorts were controlled by multivariate methods, and a subsequent analysis showed that there was a declining trend in mortality between 1968 and 1977. A higher tendency among smokers to give up smoking and a lower prevalence of angina pectoris could explain only part of the reduction in mortality. A small number of patients underwent a coronary bypass operation; the slight increase in the number of operations during the period cannot, however, account for the reduced mortality. Most of the patients in the later cohorts were treated with beta blockers, and this is the most likely explanation for the majority of the decline in mortality.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aberg A., Bergstrand R., Johansson S., Ulvenstam G., Vedin A., Wedel H., Wilhelmsson C., Wilhelmsen L. Cessation of smoking after myocardial infarction. Effects on mortality after 10 years. Br Heart J. 1983 May;49(5):416–422. doi: 10.1136/hrt.49.5.416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Craig I. H., Byrne E., Tiltman R. C. Changing mortality from ischaemic heart disease and acute myocardial infarction. Med J Aust. 1978 Nov 4;2(10):461–464. doi: 10.5694/j.1326-5377.1978.tb131642.x. [DOI] [PubMed] [Google Scholar]
- Elmfeldt D., Wilhelmsen L., Tibblin G., Vedin J. A., Wilhelmsson C. E., Bengtsson C. Registration of myocardial infarction in the city of Göteborg, Sweden. J Chronic Dis. 1975 Mar;28(3):173–186. doi: 10.1016/0021-9681(75)90005-3. [DOI] [PubMed] [Google Scholar]
- Goldberg R., Szklo M., Tonascia J. A., Kennedy H. L. Time trends in prognosis of patients with myocardial infarction: a population-based study. Johns Hopkins Med J. 1979 Mar;144(3):73–80. [PubMed] [Google Scholar]
- Hunt D., Sloman G., Christie D., Penington C. Changing patterns and mortality of acute myocardial infarction in a coronary care unit. Br Med J. 1977 Mar 26;1(6064):795–798. doi: 10.1136/bmj.1.6064.795. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Isacsson S. O., Johansson B. W. Myocardial infarction in Malmö during the 10-year period 1963--1972. Acta Med Scand. 1979;206(4):293–298. doi: 10.1111/j.0954-6820.1979.tb13513.x. [DOI] [PubMed] [Google Scholar]
- Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966 Mar;50(3):163–170. [PubMed] [Google Scholar]
- Norris R. M., Caughey D. E., Deeming L. W., Mercer C. J., Scott P. J. Coronary prognostic index for predicting survival after recovery from acute myocardial infarction. Lancet. 1970 Sep 5;2(7671):485–487. doi: 10.1016/s0140-6736(70)90110-8. [DOI] [PubMed] [Google Scholar]
- Peel A. A., Semple T., Wang I., Lancaster W. M., Dall J. L. A CORONARY PROGNOSTIC INDEX FOR GRADING THE SEVERITY OF INFARCTION. Br Heart J. 1962 Nov;24(6):745–760. doi: 10.1136/hrt.24.6.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stallones R. A. The rise and fall of ischemic heart disease. Sci Am. 1980 Nov;243(5):53–59. doi: 10.1038/scientificamerican1180-53. [DOI] [PubMed] [Google Scholar]
- Stern M. P. The recent decline in ischemic heart disease mortality. Ann Intern Med. 1979 Oct;91(4):630–640. doi: 10.7326/0003-4819-91-4-630. [DOI] [PubMed] [Google Scholar]
- Vedin A., Wilhelmsen L., Wedel H., Pettersson B., Wilhelmsson C., Elmfeldt D., Tibblin G. Prediction of cardiovascular deaths and non-fatal reinfarctions after myocardial infarction. Acta Med Scand. 1977;201(4):309–316. doi: 10.1111/j.0954-6820.1977.tb15705.x. [DOI] [PubMed] [Google Scholar]
- Vedin A., Wilhelmsson C., Elmfeldt D., Säve-Söderbergh J., Tibblin G., Wilhelmsen L. Deaths and non-fatal reinfarctions during two years' follow-up after myocardial infarction. Acta Med Scand. 1975 Nov;198(5):353–364. doi: 10.1111/j.0954-6820.1975.tb19557.x. [DOI] [PubMed] [Google Scholar]
- Weinblatt E., Goldberg J. D., Ruberman W., Frank C. W., Monk M. A., Chaudhary B. S. Mortality after first myocardial infarction. Search for a secular trend. JAMA. 1982 Mar 19;247(11):1576–1581. [PubMed] [Google Scholar]
- Wilhelmsson C., Vedin J. A., Elmfeldt D., Tibblin G., Wilhelmsen L. Smoking and myocardial infarction. Lancet. 1975 Feb 22;1(7904):415–420. doi: 10.1016/s0140-6736(75)91488-9. [DOI] [PubMed] [Google Scholar]
- Wilhelmsson C., Vedin J. A., Wilhelmsen L., Tibblin G., Werkö L. Reduction of sudden deaths after myocardial infarction by treatment with alprenolol. Preliminary results. Lancet. 1974 Nov 16;2(7890):1157–1160. doi: 10.1016/s0140-6736(74)90807-1. [DOI] [PubMed] [Google Scholar]
