Reduction in Acute Myocardial Infarction Mortality in the United States

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Abstract
Over the last 2 decades, health care professional, consumer, and payer organizations have sought to improve outcomes for patients hospitalized with acute myocardial infarction (AMI). In 1990, the American College of Cardiology and the American Heart Association jointly published the first in a series of clinical practice guidelines for AMI that include a significant emphasis on evidence-based hospital care.1 The focus on quality was augmented by initiatives supported by other public and private groups that targeted aspects of care including time to reperfusion for ST-segment elevation myocardial infarction and the use of evidence-based therapies during hospitalization, discharge, and postdischarge care.2-6 During this period of marked emphasis on improving the quality of hospital care for patients with AMI, the use of evidence-based medications increased7 and overall coronary heart disease deaths decreased.8