Citation

Nemetz PN, Roger VL, Ransom JE, Bailey KR, Edwards WD, Leibson CL. Arch. Intern. Med. 2008; 168(3): 264-270.

Affiliation

Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.

Copyright

(Copyright © 2008, American Medical Association)

DOI

10.1001/archinternmed.2007.79

PMID

18268166

Abstract

BACKGROUND: Despite increases in obesity and diabetes mellitus, mortality caused by coronary disease continues to decline. Recent trends in coronary disease prevalence are unknown. METHODS: There were 3237 deaths among Olmsted County, Minnesota, residents aged 16 through 64 years during the 1981-2004 period. Of the 515 due to accident, suicide, homicide, or a manner that could not be determined, 425 individuals (82%) had coronary anatomy graded. Pathology reports were reviewed for the grade of coronary disease (range, 0-5) assigned each of 4 arteries: left anterior descending (LAD), left circumflex (LCx), right coronary artery (RCA), and left main artery (LMA). High-grade disease was defined as more than a 75% reduction in cross-sectional luminal area (grade >or=4) in any of LAD, LCx, or RCA or more than 50% reduction (grade >or=3) in LMA. Evidence of any disease was defined as a grade higher than 0 in any artery. Calendar-year trends were analyzed as linear and nonlinear functions. RESULTS: Over the full period (1981-2004), 8.2% of the 425 individuals had high-grade disease, and 83% had evidence of any disease. Age- and sex-adjusted regression analyses revealed temporal declines over the full period (1981-2004) for high-grade disease, any disease, and grade of coronary disease. Declines in the grade of coronary disease ended after 1995 (P

Language: en