Mortality after first myocardial infarction. Search for a secular trend
E. Weinblatt, J. D. Goldberg, W. Ruberman, C. W. Frank, M. A. Monk and B. S. Chaudhary
Two earlier studies of prognosis of coronary heart disease among men
enrolled in the Health Insurance Plan in the 1960s and 1970s permitted us
to examine whether prognosis had improved over this ten-year period. The
new comparison involved 1,133 men aged 35 to 64 years who had survived a
first acute myocardial infarction and were followed up for mortality after
a baseline examination. Mortality estimates were controlled for clinical
and demographic differences between the two cohorts by multivariate methods
and by comparing subgroups. The analyses showed no difference in long-term
prognosis between patients in the two decades. The observations in this
population suggest that any contribution of improved medical care to the
nationally observed secular decline in mortality from coronary heart
disease in the time period studied was probably restricted to the acute
stage of myocardial infarction.
