ArticleBritish heart journal1995
Reduced in-hospital mortality from acute myocardial infarction with general adoption of thrombolytic treatment in the North West Thames health region 1979-1991.
Article in British heart journal, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 25 citations in OpenAlex.
- Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years.Heart (British Cardiac Society) · 2006Article
- Management and in-hospital outcome of patients with acute myocardial infarction admitted to intensive care units at the turn of the century: results from the French nationwide USIC 2000 registry.Heart (British Cardiac Society) · 2004Article
- Impact of selected geographical and clinical conditions on thrombolysis rate in myocardial infarction in three departments of France.European journal of epidemiology · 2001Article
- Article
- Hospital mortality of acute myocardial infarction in the thrombolytic era.Heart (British Cardiac Society) · 1999Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the impact of studies of thrombolytic treatment in acute myocardial infarction on inhospital mortality.
designRetrospective study.
settingAll 21 major hospitals in the North West Thames health region. PATIENTS: 63,903 patients with acute myocardial infarction. STUDY PERIOD: 1979-1991.
main outcome measuresin-hospital mortality.
resultsOverall mortality decreased by 5.2% from 25.4% to 20.2% (P < 0.0001) (95% confidence interval (CI) 3.4 to 6.6). Male mortality decreased by 6.5% from 22.3% to 15.8% (P < 0.0001) (95% CI 4.8 to 8.4); female mortality decreased by 4.3% from 32.6% to 28.3% (P < 0.01) (95% CI 1.3 to 7.4). Reductions in mortality occurred in all age and sex groups but were greater in younger patients. Logistic regression analysis of death rates showed that the odds ratio of death in 1991 compared with that in 1979 was 0.75 (95% CI 0.69 to 0.82). After allowing for the effects of age and sex, this odds ratio became 0.54 (95% CI 0.49 to 0.59), as more elderly patients were treated in 1991. Purchase of streptokinase increased 31-fold from 116 doses in 1983 to 3554 doses in 1991. There was a pronounced negative association between annual purchases of streptokinase and mortality (Kendall's rank correlation = -0.86, P = 0.003). Changes in clinical practice resulted in the saving of the lives of an estimated 600 patients with acute myocardial infarction in 1991. This extrapolates to an annual saving of 10,500 lives in the United Kingdom.
conclusionsIn the past few years thrombolytic treatment has been widely adopted for the management of acute myocardial infarction. This has been paralleled by a substantial reduction in in-hospital mortality.
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