Heart attack prevention and outcomes have dramatically improved for American adults in the past two decades, according to a Yale study in JAMA Network Open. Compared to the mid-1990s, Americans today are less likely to have heart attacks and also less likely to die from them, said the researchers. Tracking more than four million Medicare patients between 1995 and 2014, this is the largest and most comprehensive study of heart attacks in the United States to date. Its two key findings are that hospitalizations for heart attacks have declined by 38%, and the 30-day mortality rate for heart attacks is at an all-time low of 12%, down by more than a third since 1995. In the words of Dr. Harlan Krumholz, lead author and Yale cardiologist, these gains are "remarkable." The Yale cardiologist also believes these gains are no accident. Krumholz explained that the last 20 years have been marked by national efforts to prevent heart attacks and improve care for those who suffer them. The Centers for Medicare and Medicaid Services, the American College of Cardiology, and the American Heart Association - along with other organizations and "legions of researchers and clinicians and public health experts" - have focused on reducing risk by promoting healthy lifestyles, addressing risk factors, and improving the quality of care, the researchers noted.