1. 1 National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994–2004 CIHR Team Grant in Cardiovascular Outcomes Research Jack V. Tu MD PhD, Lorelei Nardi MSc, Jiming Fang PhD, Juan Liu MD, Laila Khalid MD, Helen Johansen PhD, for the Canadian Cardiovascular Outcomes Research Team

2. CCORT CCORT is a group of over 30 outcomes researchers from 5 provinces (NS, QC, ON, AB, BC) who are working together on projects to measure and improve the quality of cardiac care in Canada Funded by a CIHR Team Grant in Cardiovascular Outcomes Research Institute for Clinical Evaluative Sciences (ICES) in Toronto is the national coordinating centre for CCORT www.ccort.ca CIHR Team Grant in Cardiovascular Outcomes Research

3. Purpose of Study To examine national trends between 1994 and 2004, in hospitalizations and death rates for acute myocardial infarction, heart failure and stroke To see whether the rate of change for these three conditions has been similar or different CIHR Team Grant in Cardiovascular Outcomes Research

4. Methods We analyzed mortality data from Statistic Canada’s Canadian Mortality Database and data on hospital admissions from the Canadian Institute for Health Information’s Hospital Morbidity Database for the period 1994-2004 We determined age- and sex-standardized rates of death and hospital admissions per 100,000 population aged 20 years and over as well as in-hospital case- fatality rates CIHR Team Grant in Cardiovascular Outcomes Research

5. Overview The following is a set of slides that highlight key findings from the original manuscript including the following: – Decrease in mortality rates – Decrease in hospital admission rates – Decrease in in-hospital case-fatality rates – Differences between men and women in relation to mortality and hospitalization rates Please feel free to use these slides to disseminate this information CIHR Team Grant in Cardiovascular Outcomes Research

6. Trends in the rates of death, hospital admissions and in-hospital case fatality associated with acute myocardial infarction, heart failure and stroke in Canada, 1994-2004

7. Age- and sex-specific rates of death by cardiovascular disease per 100,000 population aged 20 and over in Canada, 1994-2004

8. Age- and sex-standardized rates of death from acute myocardial infarction, heart failure and stroke per 100,000 population aged 20 and over in Canada, 1994-2004. Rates are standardized to the Canadian 1991 census population

9. 38.1 % 23.5 % 28.2 %

11. 32.3% 27.5% 32.3%

13. Age- and sex-standardized rates of hospital admissions because of acute myocardial infarction, heart failure and stroke per 100,000 population aged 20 and over in Canada, 1994-2004. Rates are standardized to the Canadian 1991 census population.

14. 9.2 % 27.2 % 27.6 %

16. Age- and sex-adjusted in-hospital case-fatality rates among patients with acute myocardial infarction, heart failure and stroke in Canada, 1994-2004. Rates are standardized to the Canadian 1991 census population.

17. 33.1 % 8.1% 8.9 %

18. Age- and sex-specific rates of hospital admissions by cardiovascular disease per 100,000 population aged 20 and over in Canada, 1994-2004

20. Conclusions Mortality, hospitalization and in-hospital case-fatality rates for heart disease decreased significantly between 1994-2004 For the first time in Canada, more women than men died from cardiovascular disease in 2000 Efforts to prevent cardiovascular disease have been successful but may have delayed the onset of disease until people are older Further prevention, treatment and national surveillance of cardiovascular disease is continuously required as it is still the leading cause of death in Canada

21. Reasons for mortality decline Better heart disease prevention – Decreasing smoking rates – Greater awareness and control of hypertension – Decreasing cholesterol levels (i.e. statins) Better heart disease treatment – Aspirin, beta-blockers, ACE inhibitors, statins, etc. – Fibrinolytics (clot-busting drugs), – Primary angioplasty, CABG surgery

22. Funding This study was supported by a Team Grant in Cardiovascular Outcomes Research to the Canadian Cardiovascular Outcomes Research Team from the Canadian Institutes of Health Research CIHR Team Grant in Cardiovascular Outcomes Research

23. Thank You For more information please visit www.ccort.ca CIHR Team Grant in Cardiovascular Outcomes Research