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Kenrad E. Nelson, MD; Earl Ford, MD
University of Illinois College of Medicine Chicago

JAMA. 1986;256(20):2816-2817.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

We read with great interest the report of the Worcester Heart Attack Study by Goldberg et al.¹ We agree with the authors of this elegant study that it is critical that population-based epidemiologic data be collected and analyzed to determine the major reasons for the substantial decline in coronary heart disease (CHD) mortality rates in the United States in the past two decades.

In this study, the incidence and in-hospital and out-of-hospital casefatality rates for CHD were collected for the Worcester Standard Metropolitan Statistical Area for three years (1975, 1978, and 1981), during which time there was a steady decline in age-adjusted mortality from CHD. The authors conclude that the "recently observed declines in the mortality rates of CHD may reflect decreases in out-of-hospital coronary deaths and improving trends in the in-hospital survival of patients with acute myocardial infarction."

While it is true that the in-hospital . . . [Full Text PDF of this Article]

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