P. Marques-vidal et al., Incidence, recurrence, and case fatality rates for myocardial infarction in southwestern France, 1985 to 1993, HEART, 84(2), 2000, pp. 171-175
Citations number
38
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective-To assess the impact of incidence, recurrence, and case fatality
rates for myocardial infarction on coronary heart disease mortality in sout
hwestern France between 1985 and 1993.
Design-Toulouse-MONICA myocardial infarction register.
Settings and patients-All subjects aged 35 to 64 years living in the French
department of Haute-Garonne.
Interventions-All coronary artery disease events between 1985 and 1993.
Main outcome measures-7210 events collected by the register between 1985 an
d 1993.
Results-In men, adjusted attack, total, and out of hospital mortality decre
ased by 2% (95% confidence interval (CI), -3.8% to -0.1%), 6.2% (95% CI -8.
4% to -4.0%), and 4.2% (95% CI -7.0% to -1.5%) a year, respectively (p < 0.
05). Incidence and recurrence rates decreased by 2% (95% CI -4.1% to -0.1%,
p < 0.05) and 1.9% (95% CI -5.9% to 2.2%) a year (NS). In women, attack, t
otal, and out of hospital mortality decreased by 1.7% (95% CI -5.2% to 1.8%
), 4.8% (95% CI -9.6% to 0.1%), and 2.6% (95% CI -9.4% to 4.1%) a year, res
pectively; incidence decreased by 2% (95% CI -6.5% to 2.5%) and recurrence
increased by 1.4% (95% CI -9.8% to 12.6%) a year tall NS). In men, total, i
ncident, and recurrent 28 day case fatality decreased by 3.8% (95% CI -4.8%
to -2.8%), 3.2% (95% CI -4.1% to -2.3%), and 6.4% (95% CI -9.5% to -3.3%)
a year, respectively (p ( 0.05). For women, the corresponding decreases wer
e 3.3% (95% CI -6.1% to -0.6%), 3.3% (95% CT -13.2% to 6.6%), and 11.7% (95
% CI -24.6% to 1.3%) a year, but only the decrease in total 28 day case fat
ality reached significance. In both sexes, me reduction in case fatality co
ntributed nearly 70% of the decrease in myocardial infarction mortality.
Conclusions-In southwestern France, the decrease in myocardial infarction m
ortality mainly reflects improvements in acute management rather than preve
ntion.