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Early identification and treatment of acute myocardial infarction with evidence-based modalities — such as aspirin, thrombolysis, and percutaneous coronary intervention — has received increased attention in modern emergency medicine, but do our efforts improve long-term survival? As part of the World Health Organization MONICA project (monitoring trends and determinants in cardiovascular disease), researchers in Australia compared rates of 12-year survival among 4451 consecutive patients (age range, 35–64) who were admitted to hospitals with a first nonfatal AMI and survived for at least 28 days during three periods: 1984–1987, 1988–1990, and 1991–1993.
In regression analysis that controlled for age, sex, smoking status, medical history, and…