Minnesota Heart Survey - Mortality and Morbidity
Condition: Cardiovascular Diseases; Coronary Disease; Heart Diseases; Myocardial Infarction; Death, Sudden, Cardiac
MeSH terms: Cardiovascular Diseases; Heart Diseases; Myocardial Infarction; Coronary Disease; Death, Sudden, Cardiac; Infarction; Death, Sudden
Study type: Observational

Summary: 
      To continue surveillance of coronary heart disease (CHD) mortality and morbidity in the seven
      county metropolitan Minneapolis/St. Paul (Twin Cities) areas.
    

Detailed description: 
      BACKGROUND:

      The Minnesota Heart Survey (MHS) is among the few population-based longitudinal studies to
      monitor and explain trends in coronary heart disease (CHD) mortality and morbidity, the
      leading cause of death and disability in the United States. It encompasses a large and
      well-defined community, the Minneapolis/St. Paul (Twin Cities) metropolitan area of
      Minnesota, comprising a population of 2.3 million (1990 census) For almost two decade the
      Minnesota Heart Survey has made contributions to understanding 1) the components of the
      decline of coronary heart disease mortality including incidence rate, hospitalized attach
      rate, case fatality, and population levels of CHD risk factors; and 2) the methodology of
      disease surveillance in a time when classification and diagnostic technologies are constantly
      changing.

      DESIGN NARRATIVE:

      The Minnesota Heart Survey continues surveillance of coronary heart disease (CHD) mortality
      and morbidity in the seven county metropolitan Minneapolis/St. Paul (Twin Cities) areas
      through the year 2002. The study will also monitor trends in acute myocardial infarction
      (AMI), evaluate the effect on AMI diagnosis of the widespread use of new biomarkers
      (troponins), perform a validation study to the previous standard, and evaluate
      out-of-hospital sudden cardiac death (SCD) through an autopsy study

      A combination of different techniques will be used for surveillance. CHD deaths will be
      obtained from death certificate data from the Minneapolis Department of Public Health. Census
      data will be used to construct the appropriate denominators. A major focus is based on
      in-hospital CHD morbidity and mortality. Data from the Minnesota Hospital and Health Care
      Partnership, which originally receives data from 22 of the 23 area hospitals, will be used to
      identify and validate acute myocardial infarction (AMI) cases. Census data will again be used
      to obtain the appropriate denominators. An important issue in assessing time trends in
      hospitalized AMI attack rate is the changing definitions used to identify cases over time. A
      specific issue in this regard is the increasing use of troponin levels that are more
      sensitive than previously used CKMB levels to identify cases. Thus, a validation study will
      be conducted comparing these two methodologies on the same subjects. The goal of the study is
      to obtain correction factors so that time trends in AMI attack rates are not influenced by
      differences in diagnostic criteria.

      A new important area of investigation is that of out of-hospital sudden cardiac deaths (SCD).
      Autopsy studies of 100 cases per year (about 300 total) will be conducted to describe risk
      factors for SCD. In addition, comparisons will be made between a control group of 600 persons
      in the risk factor study.

      .