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Trends in the Incidence and Survival of Patients with Hospitalized Myocardial Infarction, Olmsted County, Minnesota, 1979 to 1994

Véronique L. Roger, MD, MPH; Steven J. Jacobsen, MD, PhD; Susan A. Weston, MS; Tauqir Y. Goraya, MD, PhD; Jill Killian, BS; Guy S. Reeder, MD; Thomas E. Kottke, MD, MSPH; Barbara P. Yawn, MD, MSc; and Robert L. Frye, MD
[+] Article, Author, and Disclosure Information

From the Mayo Clinic, Mayo Foundation, and Olmsted Medical Group, Rochester, Minnesota.

Acknowledgments: The authors thank Aaron R. Folsom, MD, and Robert J. Goldberg, PhD, for expert advice and insightful critique of the manuscript; Mary Henkel, Deborah C. Olson, Deanne Stiebner, Susan Stotz, Kay Traverse, Georgianna Hanson, and Patricia Perkins for assistance with data collection; and Kristie K. Shorter for secretarial assistance.

Grant Support: In part by grants from the Public Health Service and the National Institutes of Health (AR30582 and RO1 HL 59205). Véronique L. Roger is an Established Investigator of the American Heart Association.

Requests for Single Reprints: Véronique L. Roger, MD, MPH, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Current Author Addresses: Drs. Roger, Goraya, Reeder, Kottke, and Frye: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Dr. Jacobsen, Ms. Weston, and Ms. Killian: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Dr. Yawn: Olmsted Medical Group, 210 Ninth Street SE, Rochester, MN 55903.

Author Contributions: Conception and design: V.L. Roger, S.J. Jacobsen, T.E. Kottke, R.L. Frye.

Analysis and interpretation of the data: V.L. Roger, S.J. Jacobsen, B.P. Yawn.

Drafting of the article: V.L. Roger.

Critical revision of the article for important intellectual content: S.J. Jacobsen, T. Goraya, G.S. Reeder, T.E. Kottke, B.P. Yawn, R.L. Frye.

Final approval of the article: V.L. Roger.

Statistical expertise: S. Weston, J. Killian.

Obtaining of funding: V.L. Roger.

Ann Intern Med. 2002;136(5):341-348. doi:10.7326/0003-4819-136-5-200203050-00005
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From 1979 to 1994, trends in the incidence of myocardial infarction in Olmsted County differed markedly by age and sex: During this time, an 8% decrease was observed in men but a 36% increase was observed in women. An increased incidence was also observed in older persons. The 28-day case-fatality rate and overall survival improved in younger persons, whereas they remained the same in older persons. These results indicate that the shift in coronary disease mortality toward women and elderly persons observed in Olmsted County during that period (7) is linked to age- and sex-based shifts in disease incidence and survival.

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Figure 1.
Trends in the incidence of myocardial infarction from 1979 to 1994 in Olmsted County, Minnesota, in men (circles) and women (squares)

. Incidence is shown on a linear scale and was adjusted by using the direct method to the age distribution of the total U.S. population in 2000. The heavy dotted lines represent the predicted values for the trends in incidence over time based on Poisson regression model.

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Figure 2.
Observed survival after incident myocardial infarction in Olmsted County, Minnesota (solid line), and expected survival for the Minnesota population (dotted line).
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Summary for Patients

Changes in Incidence of Heart Attacks

The summary below is from the full report titled “Trends in the Incidence and Survival of Patients with Hospitalized Myocardial Infarction, Olmsted County, Minnesota, 1979 to 1994.” It is in the 5 March 2002 issue of Annals of Internal Medicine (volume 136, pages 341-348). The authors are VL Roger, SJ Jacobsen, SA Weston, TY Goraya, J Killian, GS Reeder, TE Kottke, BP Yawn, and RL Frye.


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