Trends in the home management of non‐fatal acute myocardial infarction in Perth, Western Australia between 1984 and 1993

Hc, Bell; Rw, Parsons; Kd, Jamrozik; Fritjes, C

doi:10.1111/j.1445-5994.1995.tb01523.x

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Limitations. The WADLS captures atherothrombotic events treated in hospital only and we will have missed a proportion of events that were diagnosed and treated in primary care, 33 possibly leading to conservative estimates of incidence and prevalence. In particular, our PAD population may be underestimated relative to CHD and CeVD due to greater propensity to treat lower severity PAD in a community setting.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Trends in age- and sex-specific prevalence and incidence of cardiovascular disease in Western Australia

Sarink

Nedkoff

Briffa

et al. 2018

Eur J Prev Cardiolog

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Background Temporal trends in incidence and mortality of cardiovascular disease (CVD) have been well described, with recent data suggesting declining improvements in those aged under 55 years. However, little is known about the combined impact of incidence and mortality trends on disease prevalence, an important indicator of disease burden and cost. We analysed changes in age-specific and age-standardised temporal trends in prevalence and incidence of CVD subtypes. Methods Annual prevalence and incidence rates of coronary heart disease, cerebrovascular disease and peripheral arterial disease for the Western Australian population for 1995-2010 were calculated using data from the Western Australian Data Linkage System. Joinpoint regression analyses were used to identify joinpoints in trends in age-specific and age-standardised annual prevalence and incidence rates for each CVD subtype. Results Between 1995 and 2010, age- and sex-specific incidence and prevalence of the CVD subtypes generally decreased among middle-aged and older adults, but were stable or increased among younger adults. In < 55 year olds, increases in incidence tended to occur from 2003, while increases in prevalence were from 2007/2008. Declines in age-standardised incidence were greater than those in crude incidence, with changes in population structure having a greater impact among men than women. Conclusions The majority of CVDs occurs in older adults. Our findings of generally worsening trends in prevalence in younger adults across most CVD subtypes were in contrast to generally declining trends in older age groups. These data highlight the importance of monitoring prevalence and incidence, particularly in younger adults.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Trends in age- and sex-specific prevalence and incidence of cardiovascular disease in Western Australia

Sarink

Nedkoff

Briffa

et al. 2018

Eur J Prev Cardiolog

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“…9 Our methods did not capture silent MIs or ACS events treated out of hospital. A previous study has shown that a negligible proportion of patients (Ͻ1%) with recognized nonfatal MI in Perth are treated completely in primary care, 40 and there is no evidence to suggest that this has increased. The exclusion of ACS patients who were treated in or died in an emergency department is unlikely to bias our findings because a high proportion of patients who undergo troponin testing are admitted to the hospital, and Յ1% die in the emergency department before admission.…”

Section: Study Limitationsmentioning

confidence: 99%

Age- and Sex-Specific Trends in the Incidence of Hospitalized Acute Coronary Syndromes in Western Australia

Nedkoff

Briffa

Preen

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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, MBBS, DPhil (Oxon), FRACP, FAFPHM Background-The incidence of myocardial infarction has declined during the past 4 decades in many populations.However, there are limited population data measuring trends in acute coronary syndromes (ACS). We therefore examined temporal trends in the incidence of hospitalized ACS by age and sex in a population-based cohort. Methods and Results-The Western Australian Data Linkage System, a repository of linked administrative health data, was used to identify 29 421 incident ACS hospitalizations between 1996 and 2007. Poisson log-linear regression models were used to calculate incidence rate changes. Age-standardized incidence rates of ACS declined annually in men by 1.7% (95% confidence interval [CI], Ϫ2.1 to Ϫ1.3) and in women by 1.6% (95% CI, Ϫ2.1 to Ϫ1.0). These declining rates were underpinned by annual reductions in the incidence of unstable angina (men, Ϫ3.0%; 95% CI, Ϫ3.7 to Ϫ2.4; women, Ϫ2.5; 95% CI, Ϫ3.3 to Ϫ1.7), whereas annual changes in myocardial infarction incidence were less (men, Ϫ1.0%; 95% CI, Ϫ1.5 to Ϫ0.5; women, Ϫ0.8%; 95% CI, Ϫ1.6 to 0). However, the overall trends masked age group differences, with ACS incidence increasing annually in 35-to 54-year-old women (2.3%; 95% CI, 1.0 to 3.8), predominantly driven by increasing incidence of myocardial infarction. Conclusions-The age-standardized incidence of ACS decreased significantly in Western Australia from 1996 to 2007. However, an increase in ACS incidence in women ages 35 to 54 years is troubling and warrants further investigation. (Circ Cardiovasc Qual Outcomes. 2011;4:557-564.)

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“…The safety of early discharge was demonstrated by the very low 6-month mortality rate (0.8%). Despite this initial report, safety concern of such an approach still remains, 1 as it has only been applied to a minority of patients.…”

Section: Risk Stratification and Early Discharge After Primary Angiopmentioning

confidence: 99%

“…1,2 Increasing economic pressures have intensified the need for risk scores to tailor in-hospital treatment of patients with STEMI according to their risk of future events. 3 Identification of a low-risk subset of patients seems to be an attractive way to reduce hospitalization and costs.…”

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confidence: 99%

Prognostic Assessment of Patients With Acute Myocardial Infarction Treated With Primary Angioplasty

Luca¹,

Suryapranata²,

Hof³

et al. 2004

Circulation

269

150

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Background-The aim of this study was to create a practical score for risk stratification in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty and to assess the feasibility of early discharge in low-risk patients. Methods and Results-A prognostic score was built according to 30-day mortality rates in 1791 patients undergoing primary angioplasty for STEMI. For the identified low-risk patients without any contraindication to early discharge, we estimated and compared the costs of conventional care (prolonged 24-hour hospitalization) with the costs of shifting the care from inpatient to outpatient setting (early discharge) between 48 and 72 hours. Independent predictors of 30-day mortality included in the score were age, anterior infarction, Killip class, ischemic time, postprocedural Thrombolysis In Myocardial Infarction (TIMI) flow, and multivessel disease. This score was able to identify a large cohort (73.4%) of low-risk (score Յ3) patients, with a good discriminatory capacity (c statisticϭ0.907). The mortality rate was 0.1% at 2 days and 0.2% between 2 and 10 days in patients with a score Յ3. The incremental cost-effectiveness ratio for late discharge in low-risk patients was estimated at €1949.33. Therefore, this policy would save 1 life per 1097 low-risk patients, at additional costs of €194 933.33, in comparison with an early discharge policy. Conclusions-This score is a practical and useful index for risk stratification after primary angioplasty for STEMI, with a significant impact on clinical decision-making and the related costs. It reliably identifies a large group of patients at very low risk, who may safely be discharged early after primary angioplasty.

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Trends in the home management of non‐fatal acute myocardial infarction in Perth, Western Australia between 1984 and 1993

Abstract: The management at home of cases of non-fatal AMI in people of working age in Perth has remained at a negligible level from 1984 to 1993. Thus a register based on admissions to hospital for AMI will accurately reflect trends in AMI in people of working age.

Cited by 6 publications

References 6 publications

Trends in age- and sex-specific prevalence and incidence of cardiovascular disease in Western Australia

Trends in age- and sex-specific prevalence and incidence of cardiovascular disease in Western Australia

Age- and Sex-Specific Trends in the Incidence of Hospitalized Acute Coronary Syndromes in Western Australia

Prognostic Assessment of Patients With Acute Myocardial Infarction Treated With Primary Angioplasty

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