Explaining trends in heart attack

A report in Circulation from the Framingham Heart Study, which compared acute myocardial infarction (AMI) incidence in 9824 men and women over four decades, has proposed an explanation for the apparent paradox of improved prevention, falling mortality rates but stable rates of hospitalisation. The study found that over the past 40 years rates of AMI diagnosed by ECG decreased by 50%, whereas rates of AMI diagnosed exclusively by infarction biomarkers doubled. This 'evolving' diagnosis of AMI, say the investigators, 'offers an explanation for the apparently steady national AMI rates in the face of improvements in primary prevention'...

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