Project: Research project

Project Details


DESCRIPTION: (Adapted from Investigator's Abstract) Cardiovascular disease
remains the leading cause of death in the U.S. Despite an encouraging
decline in age-adjusted coronary heart disease (CHD) mortality, prevalent
CHD continues to represent a major health burden, particularly in the
elderly population. Most community surveillance programs, however, cannot
fully characterize this problem because they are restricted to an upper age
limit of 74 years and thus do not include the events occurring in an
increasingly growing part of the population. Observational studies have
questioned the existence of a change over time in the prevalence of anatomic
coronary disease either at post-mortem examination or at coronary
angiography. This remains to be further examined in a population-based
setting. In addition, the natural history of myocardial infarction (MI) in
the reperfusion area is unknown; in particular, there are no
population-based data on the incidence of post-MI heart failure.

The investigators propose to study the entire population of Olmsted County,
Minnesota, including all age categories, to examine the secular trends in
CHD mortality, MI incidence, and natural history, including MI severity,
case fatality and post-MI morbidity. In addition, because of the uniquely
high autopsy rate in Olmsted County, the time trends in the prevalence of
CHD at post-mortem will be examined. The investigators point out that the
Olmsted County population constitutes a valuable resource for ascertainment
of MI incidence, morbidity and case fatality rate. In particular, since all
inpatient and outpatient medical encounters are present in a single medical
record unit, this study will have the capabilities of measuring the
incidence of post-MI heart failure and its hypothesized change over time.
The records of all Olmsted County residents with a hospital discharge
diagnosis of MI between 1979 and 1999 will be reviewed, and standard
epidemiologic MI validation criteria will be applied; post-MI outcome over
time will be determined, including post-MI heart failure, angina, 30 day
case fatality and long-term survival. In parallel with the analysis of time
trends in CHD mortality, the autopsy reports will be reviewed to examine
whether the prevalence of coronary disease at autopsy has changed over time.
The investigators state that these studies will provide an assessment of the
clinical and anatomical manifestations of CHD, including the outcome of
acute MI, over a time period characterized by intensified primary prevention
efforts and major changes in the treatment of acute CHD.
Effective start/end date1/15/985/31/14


  • Medicine(all)