Improving trends in 12-year survival after heart attack

A study of more than 4,000 West Australian heart attack victims has revealed improving survival trends, according to a paper published in the British Medical Journal and co-authored by Research Fellow Dr Tom Briffa of the University of Western Australia’s School of Population Health. 

During the study, researchers followed the outcomes for 12 years of 4,451 patients admitted to hospital during 1984–7, 1988–90 and 1991–3. They found that changes in the management of these patients probably resulted in the continuing decline in mortality from coronary heart disease in Australia.  

The use of proven medical treatment, such as B-blockers and revascularisation surgery within 12 months of hospital admission accounted for the greatest improvement of survival over 12 years, they claimed.

Only patients who survived 28 days after a heart attack were included in the long-term, Perth-based study.  Participants were aged from 35 to 64.  Overall, 18% were women, 10% had a history of diabetes, 51% were current smokers, and 40% had a history of high blood pressure.

"The improvement in the 1991–3 subcohort compared with the 1984–7 and 1988–90 subcohorts was significant," the authors wrote.  "The differences in survival across the three subcohorts persisted after adjustment for age, sex and coronary risk factors."

"In practical terms, proportionately 9% fewer cardiovascular deaths occurred over 12 years in the 1991–3 subcohort than in the 1984–7 subcohort.  Improvements in long-term survival are probably attributable to a combination of various treatments rather than any single treatment. Changes in lifestyle characteristics and dietary practices might also have contributed to trends in survival."

(Source: University of Western Australia: British Medical Journal: February 2009)