Life Sciences Commons^™

Communitywide Trends In The Use And Outcomes Associated With Beta-Blockers In Patients With Acute Myocardial Infarction: The Worcester Heart Attack Study, Helme Silvet, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the benefits associated with beta-blocker therapy in patients with acute myocardial infarction (AMI), limited recent data are available describing the extent of use of this therapy and the associated hospital and long-term outcomes, particularly from the perspective of a population-based study. Data are also limited about the characteristics of patients with AMI who do not receive beta-blockers. This study examines more than 2 decades of trends in the use of beta-blockers in hospitalized patients with AMI. METHODS: Communitywide study of 10,374 patients hospitalized with confirmed AMI in all metropolitan Worcester hospitals during 12 annual periods between 1975 and …

Two-Decade-Long Trends (1975-1997) In The Incidence, Hospitalization, And Long-Term Death Rates Associated With Complete Heart Block Complicating Acute Myocardial Infarction: A Community-Wide Perspective, Frederick Spencer, Samer Jabbour, Darleen Lessard, Jorge Yarzebski, Shmuel Ravid, Virginia Zaleskas, Michael Hyder, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The purpose of this community-wide study was to describe a >2-decade-long experience (1975-97) in the incidence and death rates associated with complete heart block (CHB) in patients with acute myocardial infarction (AMI). Limited population-based data exist describing recent, and changes with time therein, incidence and case-fatality rates associated with CHB complicating AMI.

METHODS: We conducted an observational study of 9082 metropolitan Worcester, Mass, residents (1990 census = 437,000) hospitalized with validated AMI in all greater Worcester hospitals during 11 1-year periods between 1975 and 1997.

RESULTS: Overall, CHB developed in 5.0% of patients with AMI. The incidence rates of …

A 30-Year Perspective (1975-2005) Into The Changing Landscape Of Patients Hospitalized With Initial Acute Myocardial Infarction: Worcester Heart Attack Study, Kevin Floyd, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, James Dalen, Joseph Alpert, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The effects of lifestyle changes and evolving treatment practices on coronary disease incidence rates, demographic and clinical profile, and the short-term outcomes of patients hospitalized with acute myocardial infarction have not been well characterized. The purpose of this study was to examine multidecade-long trends (1975-2005) in the incidence rates, demographic and clinical characteristics, treatment practices, and hospital outcomes of patients hospitalized with an initial acute myocardial infarction from a population-based perspective. METHODS AND RESULTS: Residents of the Worcester, Mass, metropolitan area (median age, 37 years; 89% white) hospitalized with an initial acute myocardial infarction (n=8898) at all greater-Worcester medical …

Twenty Year Trends (1975-1995) In The Incidence, In-Hospital And Long-Term Death Rates Associated With Heart Failure Complicating Acute Myocardial Infarction: A Community-Wide Perspective, Frederick Spencer, Theo Meyer, Robert Goldberg, Jorge Yarzebski, Mark Hatton, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

OBJECTIVES: To describe from a population-based perspective, recent and temporal (1975-1995) trends in the incidence, in-hospital and postdischarge case-fatality rates of heart failure (HF) complicating acute myocardial infarction (AMI). BACKGROUND: Extremely limited data are available describing the incidence and case-fatality rates associated with HF complicating AMI from a community-wide perspective. METHODS: The medical records of 6,798 residents of the Worcester, Massachusetts metropolitan area with validated MI and without previous HF hospitalized in 10 annual periods between 1975 and 1995 were reviewed. RESULTS: The proportion of AMI patients developing HF during hospitalization declined between 1975-1978 (38%) and 1993-1995 (33%) (p < 0.001). …

Temporal Trends (1986-1997) In Cholesterol Level Assessment And Management Practices In Patients With Acute Myocardial Infarction: A Population-Based Perspective, Jorge Yarzebski, Frederick Spencer, Robert Goldberg, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

BACKGROUND: Elevated serum cholesterol levels are associated with increased risk for acute myocardial infarction (AMI) and adverse patient outcomes. It is unclear what proportion of patients have their serum cholesterol levels measured during hospitalization for AMI and are given hypolipidemic therapy. OBJECTIVE: To examine decade-long trends in measurement of serum cholesterol levels during hospitalization for AMI and use of hypolipidemic therapy. METHODS: Observational study of 5204 residents of the Worcester, Mass, metropolitan area hospitalized with validated AMI in all greater Worcester hospitals in seven 1-year periods from 1986 through 1997. RESULTS: Increases in the measurement of serum cholesterol levels during …