Mortality after first myocardial infarction. Search for a secular trend

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Abstract
Two earlier studies of prognosis of coronary heart disease among men enrolled in the Health Insurance Plan in the 1960s and 1970s permitted an examination of whether prognosis had improved over this 10 yr period. The new comparison involved 1133 men aged 35-64 yr who had survived a first acute myocardial infarction and were followed up for mortality after a baseline examination. Mortality estimates were controlled for clinical and demographic differences between the 2 cohorts by multivariate methods and by comparing subgroups. The analyses showed no difference in long-term prognosis between patients in the 2 decades. The observations in this population suggest that any contribution of improved medical care to the nationally observed secular decline in mortality from coronary heart disease in the time period studied was probably restricted to the acute stage of myocardial infarction.