Dates of Project: 2007 through 2011

Field of Work: Expanding a statewide database on heart attacks to include information on strokes

Problem Synopsis: In 2007 the Myocardial Infarction Data Acquisition System (MIDAS) at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School included data for more than 500,000 New Jersey heart attack patients with 20-year follow-up, and was the only database to include information on virtually all heart attacks in a state. The database also had the potential to provide similar information regarding stroke patients, an affliction that according to the CDC accounts for some 137,000 deaths a year in the United States.

Synopsis of the Work: The research team expanded MIDAS to include data on more than 900,000 stroke hospital admissions in New Jersey from 1994 through 2009. They used the new data, as well as existing information, to conduct research leading to the publication of 21 articles in professional journals. Key studies focused on mortality trends from heart attack, the effect of weekend versus weekday hospital admissions for strokes, and the effect of statin drugs in decreasing cardiovascular events in women.

Key Findings:

• The percentage of New Jersey stroke patients who died within 90 days of hospital admission was significantly greater for those admitted on weekends and holidays compared with weekdays (17.2% versus 16.5%).
• Between 1986 and 2007, in-hospital deaths from heart attack in New Jersey decreased from 16.9 percent to 7.5 percent. However, deaths occurring from 30 days after discharge out to one year after discharge increased by 1.2 percent. The increase was especially evident among older age groups and was due to deaths that were unrelated to cardiovascular events. This suggests that the improvement of long-term outcomes requires expanding care strategies beyond the boundaries of the heart to target chronic diseases.
• Statin therapy is associated with significant decreases in cardiovascular events and in all-cause mortality in both women and men. Statin therapy therefore should be used in appropriate patients without regard to sex.