Therapy and PreventionMultidecade-long trends (1986–2005) in the utilization of coronary reperfusion and revascularization treatment strategies in patients hospitalized with acute myocardial infarction: a community-wide perspectiveWasser, Jareda; Goldberg, Robert J.b; Spencer, Frederick A.c; Yarzebski, Jorgeb; Gore, Joel M.bAuthor Information aDepartment of Community Health, Brown University, Providence, Rhode Island bDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA cDepartment of Medicine, McMaster University, Ontario, Canada Correspondence to Robert J. Goldberg, PhD, Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA Tel: +508 856 3991; fax: +508 856 4596; e-mail: [email protected] Received 19 August 2008 Accepted 25 September 2008 Coronary Artery Disease: January 2009 - Volume 20 - Issue 1 - p 71-80 doi: 10.1097/MCA.0b013e32831bb4aa Buy Metrics Abstract Objectives The objectives of our community-wide investigation were to describe multidecade-long trends (1986–2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI). Methods The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005. Results Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during hospitalization for AMI increased moderately in the 1990s, remained stable thereafter, and declined to being performed in 3.8% of hospitalized patients in 2005. The use of thrombolytic therapy increased between 1986 and 1995 (9.3–25.2%) and decreased markedly thereafter through 2005 (<1%). Demographic and clinical characteristics of several patients were associated with the receipt of these treatment regimens. Conclusion The results of this study in residents of a large Central New England community suggest an increasingly invasive approach to the management of patients hospitalized with AMI. © 2009 Lippincott Williams & Wilkins, Inc.