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- Luepker, Russell V., et al.
(författare)
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Community education for cardiovascular disease prevention. Morbidity and mortality results from the Minnesota Heart Health Program
- 1996
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Ingår i: American Journal of Epidemiology. - 0002-9262. ; 144:4, s. 351-362
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Tidskriftsartikel (refereegranskat)abstract
- The Minnesota Heart Health Program was a community trial of cardiovascular disease prevention methods that was conducted from 1980 to 1990 in three Upper Midwestern communities with three matched comparison communities. A 5- to 6-year intervention program used community-wide and individual health education in an attempt to decrease population risk. A major hypothesis was that the incidence of validated fatal and nonfatal coronary heart disease and stroke in 30- to 74-year-old men and women would decline differentially in the education communities after the health promotion program was introduced. This hypothesis was investigated using mixed-model regression. The intervention effect was modeled as a series of annual departures from a linear secular trend after a 2-year lag from the start of the intervention program. In the education communities, 2,394 cases of coronary heart disease and 818 cases of stroke occurred, with 2,526 and 739 cases, respectively, being seen in the comparison communities. The overall decline in coronary heart disease incidence was 1.8 percent per year in men (p = 0.03) and 3.6 percent per year in women (p = 0.007). For stroke, there were no significant secular trends. The authors recently published findings showing minimal effects of sustained intervention on risk factor levels. In the current report, there was no evidence of a significant intervention effect on morbidity or mortality, either for coronary heart disease or for stroke.
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- Blohm, M, et al.
(författare)
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Reaction to a media campaign focusing on delay in acute myocardial infarction
- 1991
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 20:6, s. 661-666
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Tidskriftsartikel (refereegranskat)abstract
- A media campaign conducted to reduce delay time and to increase the use of ambulance transport in acute myocardial infarction was performed in an urban area with about half a million inhabitants during 1 year. The main message was that chest pain lasting more than 15 minutes might indicate acute myocardial infarction; dial 90,000 immediately for ambulance transport to the hospital. The target population was the general public. After 6 and 12 months 400 and 610 randomly chosen persons, respectively, were contacted by telephone to evaluate the reaction of the general public to the campaign. Of these, 60% and 71%, respectively, had heard of the campaign, and all parts of the message were spontaneously remembered by 15% and 19%, respectively. The reaction to the campaign was generally positive. Among all patients admitted to the coronary care unit of one of the two city hospitals, 65% were aware of the campaign and 31% of them were of the opinion that they came to the hospital faster because of the campaign. In conclusion, a media campaign aimed at reducing patient delay time in acute myocardial infarction was shown to reach a majority of people in the community and patients with ischemic heart disease. The reaction was positive and about one fifth of interviewed people spontaneously remembered the total message.
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- Engdahl, J, et al.
(författare)
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The epidemiology of out-of-hospital "sudden" cardiac arrest
- 2002
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 52:3, s. 235-245
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Tidskriftsartikel (refereegranskat)abstract
- It is difficult to assemble data from an previous termout-of-hospital cardiac arrestnext term since there is often lack of objective information. The true incidence of previous termsudden cardiacnext term death previous termout-of-hospitalnext term is not known since far from all of these patients are attended by emergency medical services. The incidence of previous termout-of-hospital cardiac arrestnext term increases with age and is more common among men. Among patients who die, the probability of having a fatal event outside previous termhospitalnext term decreases with age; i. e. younger patients tend to more often die unexpectedly and outside previous termhospital.next term Among the different initial arrhythmias, ventricular fibrillation is the most common among patients with previous termcardiacnext term aetiology. The true distribution of initial arrhythmias is not known since several minutes most often elapse between collapse and rhythm assessment. Most patients with previous termout-of-hospital cardiac arrestnext term have a previous termcardiacnext term aetiology. previous termOut-of-hospital cardiac arrestsnext term most frequently occur in the patient's home, but the prognosis is shown to be better when they occur in a public place. Witnessed previous termarrest,next term ventricular fibrillation as initial arrhythmia and cardiopulmonary resuscitation are important predictors for immediate survival. In the long-term perspective, previous termcardiac arrestnext term in connection with acute myocardial infarction, high left ventricular ejection fraction, moderate age, absence of other heart failure signs and no history of myocardial infarction promotes better prognosis. Still there is much to learn about time trends, the influence of patient characteristics, comorbidity and previous termhospitalnext term treatment among patients with prehospital previous termcardiac arrest.
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- Herlitz, Johan, et al.
(författare)
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Effect of media campaign on delay times and ambulance use in suspected acut myocardial infarction
- 1989
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Ingår i: American Journal of Cardiology. - : Excerpta Medica, Inc.. - 0002-9149 .- 1879-1913. ; 64:1, s. 90-93
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Tidskriftsartikel (refereegranskat)abstract
- The early phase in suspected acute myocardial infarction (AMI) is particularly critical. More than 50% of deaths from coronary artery disease occur outside the hospital mainly due to ventricular fibrillation.1 Recent experiences strongly indicate that early intervention with thrombolysis2–4 and β blockers5,6 can limit myocardial damage and thereby improve prognosis. Delay times in suspected AMI have remained stable over the years. Therefore, a media campaign was started in the urban area of Göteborg, Sweden, with the intention to shorten delay times and to increase ambulance use in patients with suspected AMI.
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- Herlitz, Johan, 1949, et al.
(författare)
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Epidemiology of acute myocardial infarction with the emphasis on patients who did not reach the coronary care unit and non-AMI admissions
- 2008
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Ingår i: International Journal of Cardiology. - : Elsevier Ireland Ltd. - 1874-1754 .- 0167-5273. ; 128:3, s. 342-349
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the characteristics and outcome of patients with acute myocardial infarction (AMI) in a community, with particular emphasis on those who never reached a Coronary Care Unit (CCU) and those in whom the primary diagnosis was something other than a heart attack. METHODS: Patients hospitalised in the city of Goteborg, Sweden, and discharged (dead or alive) with a diagnosis of AMI. RESULTS: Among 1423 patient admissions the mean overall age was 75 years (81 years and 79 years in the two subsets). Among all patients, 33% had a history of heart failure and 20% had a history of cerebrovascular disease. The figures were even higher in the two subsets which were evaluated. In overall terms, an invasive strategy (coronary angiography) was used in 32% (in 5% and 9% in the two subsets respectively). The overall one-year and three-year mortality rate was 30% and 44% respectively. The three-year mortality rate among patients not admitted to a CCU was 65% and, among patients with no suspicion of a heart attack on admission, it was 68%. CONCLUSION: Even in the 21st century, patients with AMI who reach hospital alive run a high risk of death and nearly half are dead within the first three years. In overall terms, patients are characterised by high age and high co-morbidity. Among patients who do not reach a CCU and among patients with no suspicion of AMI on admission, approximately two thirds are dead within the subsequent three years.
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