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Results suggest that smoking, use of calcium channel blockers, diabetes, and obesity are risk factors for late AMD in women. However, the association of late AMD with systolic blood pressure and the effects of other CVD risk factors on early AMD need to be further explored.

for the Myocardial Infarction Data Acquisition System (MIDAS 15) Study Group Background and Purpose-Hospital staffing may be reduced on weekends. Prior studies of weekend disparities in stroke care have focused on in-hospital mortality with variable results. We hypothesized that 90-day mortality was higher in patients with stroke hospitalized on weekends versus weekdays, and this difference has been minimized over time by improvements in organization and delivery of stroke care. Methods-We used the Myocardial Infarction Data Acquisition System administrative database, which includes data on patients discharged with a primary diagnosis of cerebral infarction from all nonfederal acute care hospitals in New Jersey between 1996 and 2007. Out-of-hospital deaths were assessed by matching MIDAS records with New Jersey death registration files. New Jersey hospitals are designated by the state as comprehensive stroke centers, primary stroke centers, or nonstroke centers. The primary outcome measure was 90-day all-cause mortality after hospital admission. Results-A total of 134 441 patients were admitted with a primary diagnosis of cerebral infarction during the study period.A total of 23.4% were admitted to a comprehensive stroke center, 51.5% to a primary stroke center, and 25.1% to a nonstroke center. Ninety-day mortality was greater in patients with stroke admitted on weekends compared with weekdays (17.2% versus 16.5%; Pϭ0.002). The adjusted risk of death at 90 days was significantly greater for weekend admission (hazard ratio, 1.05; 95% CI, 1.02 to 1.09). No difference in 90-day mortality was observed for patients admitted to comprehensive stroke centers on weekends versus weekdays (hazard ratio, 1.01; 95% CI, 0.95 to 1.08). Conclusions-Patients

for the Myocardial Infarction Data Acquisition System (MIDAS14) Study Group Background-We assessed trends in the prognosis of patients with acute myocardial infarction hospitalized in New Jersey hospitals. In recent decades, in-hospital mortality has declined markedly but the decline in longer-term mortality is less pronounced, implying that mortality after discharge has worsened. Methods and Results-Using the Myocardial Infarction Data Acquisition System (MIDAS), we examined the outcomes of 285 397 patients hospitalized for a first acute myocardial infarction between 1986 and 2007. Mortality at discharge decreased by 9.4% from 16.9% to 7.5% (annual change, Ϫ0.44; 95% confidence interval, Ϫ0.49 to Ϫ0.40), but the decrease at 1 year was less pronounced (6.4%) because of an increase in mortality from discharge to 1 year after discharge (from 12.1% to 13.9%; annual change, ϩ0.15; 95% confidence interval, ϩ0.10 to ϩ0.20). Mortality from 30 days after discharge to 1 year, a measure not affected by length of stay, increased by 1.2% (annual change, ϩ0.10; 95% confidence interval, ϩ0.06 to ϩ0.23). The effect was more evident in the older age groups and was due to noncardiovascular mortality, especially from respiratory and renal diseases, septicemia, and cancer. All effects remained statistically significant (PϽ0.0001) after adjustment for demographics, comorbidities, infarction type, complications, and interventions. Piecewise linear regressions confirmed these trends. Conclusions-Postdischarge mortality of patients with acute myocardial infarction is increasing, primarily because of higher noncardiovascular mortality in the older age groups. (Circ Cardiovasc Qual Outcomes. 2010;3:581-589.)Key Words: epidemiology Ⅲ mortality Ⅲ myocardial infarction I n recent decades, a marked decrease of in-hospital mortality of patients with acute myocardial infarction (AMI) has been documented in clinical trials, in prospective registries, and in epidemiological studies. [1][2][3][4][5] Although longer-term mortality of AMI has also declined, in some studies this decline is less pronounced than mortality at discharge, implying that mortality after discharge has worsened. 1,4,6 -9 In recent years, AMI patients are older and have more comorbidities, the length of hospital stay has decreased, the diagnostic criteria have changed, and better control of risk factors may have resulted in smaller AMIs. 4 -6,9 -12 Many improvements have been made in the management of AMI and in secondary prevention with reperfusion, medications, revascularization, and emphasis on process improvement. 1,3,4,6,7,[13][14][15][16][17][18] Editorial see p 568The purpose of the present study was to examine mortality trends observed among AMI patients admitted to New Jersey hospitals while considering changes in patient characteristics, comorbidities, complications, interventions, and length of stay. Methods Data SourcesThe data for this study were obtained from the Myocardial Infarction Data Acquisition System (MIDAS) from January 1, 1986, to December 31, 2008...