For the most important advance during the early years of NEJM, you voted for the beginning of ether anesthesia. From 1880-1929, it was the first description of platelets, and from 1930-1959, the beginning of bone marrow transplantation. The 1960s brought us studies on an attenuated measles vaccine, and the first oral ACE inhibitor was introduced in the 1970s. What was the most important article reported in NEJM in the 1980s? Vote now!
A case series published in 1980 described patients with ventricular arrhythmias refractory to medical therapy who were treated with an implanted automatic defibrillator, now known as the implantable cardioverter-defibrillator (ICD). This was the first human test and involved three patients, including a teenager.
Until this article was published in 1981, radical mastectomy was the treatment of choice for breast cancer. The data showed no difference between the mastectomy and lumpectomy-plus-radiation groups in disease-free or overall survival after 7 years of follow-up; 25 years of follow-up also showed no survival difference.
Three 1981 papers described the clinical course of 15 patients – first reported in the CDC’s Morbidity and Mortality Weekly Report – with the disease originally called GRID, which eventually became known as AIDS.
On December 2, 1982, Dr. William DeVries performed the first implantation of a permanent artificial heart. Barney Clark, a 61-year-old man with end-stage congestive heart failure, was considered ineligible for heart transplant because of his age and severe emphysema. The device, a Jarvik-7 artificial heart, was made of aluminum and polyurethane. Mr. Clark lived for 112 days.
In a randomized controlled trial, stopped early for efficacy, 325 mg of aspirin taken every other day had a “statistically extreme” beneficial effect on nonfatal and fatal myocardial infarction. After an average of 4.8 years of follow-up, the total number of myocardial infarctions among those taking aspirin had been reduced by nearly half.