M. Rosen et al., Attack rate, mortality and case fatality for acute myocardial infarction in Sweden during 1987-95. Results from the National AMI Register in Sweden, J INTERN M, 248(2), 2000, pp. 159-164
Citations number
19
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective. To assess trends in attack rate, mortality and case-fatality of
acute myocardial infarction (AMI) in Sweden.
Setting. All 303 324 Swedes discharged from hospitals, or deceased, with a
diagnosis of AMI between 1987 and 1995.
Design. Analysis based on the National AMI Register in Sweden. The National
AMI Register was assembled by linking the records of the National Hospital
Discharge Register and the National Cause of Death Register in Sweden.
Main outcome measures. Age-standardized attack rate, mortality and case fat
ality rates for AMI.
Results. Between 1987 and 1995, the age-standardized attack rate of AMI dec
lined by 11% for men and 10% for women, whilst mortality from AMI decreased
by 14% for both sexes. The decrease was most pronounced for men below the
age of 64, with a reduction of 22% in attack rate and nearly 30% in mortali
ty. There was no change over time in the case fatality rates on the date of
attack, including also deaths outside hospital, whilst case fatality withi
n 28 days decreased from 49 to 45% amongst men, and 45 to 42% amongst women
. This reduction persisted over 1 year of follow-up.
Conclusions. The decrease in attack rate of AMI in Sweden may be attributed
both to changes in risk factors amongst the population and to improved med
ical intervention. The decline in case fatality rates indicates that improv
ed treatment of patients with AMI has contributed to the reduction in morta
lity. However, the high, and essentially unchanged, proportion of deaths ou
tside hospital stresses the importance of disease prevention.