Decline in death rates for coronary heart disease and severity of acute myocardial infarction in patients hospitalised with acute myocardial infarction: a Western Australian linked data study

Harjit Kaur

Research output: ThesisMaster's Thesis

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Abstract

Background: Coronary heart disease (CHD) is a major public health concern due to its impact on the health care system and the community. Since the late 1960s there has been a decline in age standardised rates of CHD mortality. It is postulated that an improvement in trends of the markers of severity of acute myocardial infarction (AMI) may have contributed to this decline. However, there is little research on the changes in trends in AMI severity, especially in Australia, to establish or negate a causal link.

Methods: The primary aim was to examine changes in indicators of AMI severity and its contribution to the decline in coronary heart disease mortality for patients admitted to hospital or incident AMI from 1984 to 2003, aged 35‐64 years. Data were obtained from historical case report forms from previous Western Australian research including the state‐wide Hospital Morbidity Data Collection, a core dataset of the Western Australian Data Linkage System.

Results: There was an increase in the Charlson comorbidity severity, renal failure, mean PREDICT final score, odds of having a positive CK‐MB and CK results and ST elevation (women only). There was a decrease in ECG severity and in the odds of having an abnormal SBP. The components of shock and clinical history had opposing changes in severity for men only, with a decrease in shock and an increase in clinical history.

Conclusion: The decline in CHD mortality was not shown to be due to a decreasing trend in AMI severity. Hence the need to continue Public Health measures to control AMI severity.
Original languageEnglish
QualificationMasters
Awarding Institution
  • The University of Western Australia
Award date7 Jun 2016
Publication statusUnpublished - 2015

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