Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.
View Article and Find Full Text PDFContext: Few studies have examined the association between the number of coronary heart disease risk factors and outcomes of acute myocardial infarction in community practice.
Objective: To determine the association between the number of coronary heart disease risk factors in patients with first myocardial infarction and hospital mortality.
Design: Observational study from the National Registry of Myocardial Infarction, 1994-2006.
Background: Among patients with ST-segment elevation myocardial infarction (STEMI), rapid reperfusion is associated with improved mortality. As such, door-to-needle (D2N) and door-to-balloon (D2B) times have become metrics of quality of care and targets for intense quality improvement.
Methods: The National Registry of Myocardial Infarction (NRMI) collected data regarding reperfusion therapy, its timing and in-hospital mortality among STEMI patients from 1990 through 2006.
Objectives: To determine whether hospitals are capable of delivering myocardial reperfusion therapy in a manner consistent with the American College of Cardiology/American Heart Association guidelines. DATA SOURCE AND STUDY SETTING: Data from the National Registry of Myocardial Infarction (NRMI)-2 and NRMI-3 were used. NRMI is an observational study, sponsored by Genentech, conducted from June 1994 through June 2000 and involving 1876 hospitals and 1,310,030 patients across the United States.
View Article and Find Full Text PDFUtilization rates of aspirin, beta blockers, angiotensin-converting enzyme inhibitors, and statins singly and as part of a multidrug regimen before hospitalization were measured in 109,540 patients with a history of coronary artery disease presenting with acute myocardial infarction to 1,283 hospitals participating in the National Registry of Myocardial Infarction-4. The profile of patients receiving none or only 1 of these therapies was compared with that of patients receiving any 3 or all 4 agents. Most patients (58%) with a history of coronary artery disease presenting with acute myocardial infarction were on none or only 1 of these effective medications at hospital admission.
View Article and Find Full Text PDFBackground: Many factors precipitate the transfer of patients hospitalized for acute myocardial infarction, including clinical status and the need for diagnostic testing and therapeutic interventions not available at the admitting hospital. The objectives of this study were to assess the frequency of transfer to another hospital and to determine whether nonmedical factors, such as age, sex, race, and insurance status, are associated with transfer.
Methods: We conducted a prospective study of patients with acute myocardial infarction who were enrolled in the National Registry of Myocardial Infarction 2 from June 1994 through March 1998.