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Introduction

  • Thomas A Pearson
    Correspondence
    Address for reprints: Thomas A. Pearson, MD, PhD, 255 Crittenden Boulevard, Helenwood Hall, Fourth Floor, Room 4-W150, Rochester, New York 14620
    Affiliations
    Department of Community and Preventive Medicine, University of Rochester, Preventive Cardiology Clinic, Strong Memorial Hospital, Rochester, New York, USA
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  • William E Boden
    Affiliations
    University of Connecticut School of Medicine, Division of Cardiology, Hartford Hospital, Hartford, Connecticut, USA
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      Between 1900 and 1950, the percentage of deaths from cardiovascular disease in the United States increased from approximately 15% of the population to over 50%.

      National Center for Health Statistics. Vital statistics of the United States, 1990-1995. Vol. 2. Mortality. Part A. Washington, D.C.: Government Printing Office, 1990–1995.

      Since1968, however, the rate of deaths from coronary artery disease has begun a steady decline, with age-adjusted mortality rates for coronary artery disease decreasing annually.

      Morbidity and mortality: 1996 chartbook on cardiovascular, lung and blood diseases. Bethesda, Md.: National Heart, Lung, and Blood Institute, 1996.

      Case fatality rates for 28 days after acute myocardial infarction (MI) in the United States have also decreased dramatically since the inception of coronary care units in 1962.

      Antman EM, Braunwald E. Acute myocardial infarction. In: Braunwald E, ed. Heart Disease: a Textbook of Cardiovascular Medicine. 5th ed. Philadelphia: WB Saunders, 1997:1184–1288.

      Before that time, MI case fatality rates averaged around 30%. With the development of defibrillation and hemodynamic monitoring over the following 20 years, 28-day death rates decreased by 50%. Since 1984, reperfusion techniques and β-blocker and aspirin therapy have reduced the death rate by another 50%, to case fatality rates much less than 10%.
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      References

      1. National Center for Health Statistics. Vital statistics of the United States, 1990-1995. Vol. 2. Mortality. Part A. Washington, D.C.: Government Printing Office, 1990–1995.

      2. Morbidity and mortality: 1996 chartbook on cardiovascular, lung and blood diseases. Bethesda, Md.: National Heart, Lung, and Blood Institute, 1996.

      3. Antman EM, Braunwald E. Acute myocardial infarction. In: Braunwald E, ed. Heart Disease: a Textbook of Cardiovascular Medicine. 5th ed. Philadelphia: WB Saunders, 1997:1184–1288.

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