Declining trend in the in-hospital case-fatality rate from acute myocardial infarction in Miyagi Prefecture from 1980 to 1999

The case-fatality rate from acute myocardial infarction (AMI) appears to ha ve been declining in recent decades, so the present study reviewed the tren d in in-hospital case-fatalities from AMI in Miyagi Prefecture, Japan, 1980 -1999. The causes of death and the effects of gender and age on the trend w ere also analyzed. From the AMI registration database of the Miyagi Study G roup for AMI, 12,961 cases of AMI were analyzed. The 30-day in-hospital cas e-fatality was calculated from the data for 1980-1999: data for causes of d eath were available for 1980-1997, and the data concerning primary percutan eous transluminal coronary angioplasty (PTCA) for AMI were available for 19 97-1999. The in-hospital case-fatality rate declined from 17.0% in the earl y 80s to 7.3% in the late 90s (approximately 57% reduction). The in-hospita l case-fatality rate was higher in female patients. Rhythm failure substant ially decreased in the late 1980s. Pump failure is decreasing, but is still the biggest problem. The in-hospital case-fatality rate was significantly lower in patients received PTCA. The declining trend in the in-hospital cas e-fatality rate suggests the benefits of current therapeutic procedures, in cluding primary PTCA, for AML Pump failure is an important target for furth er decreasing the trend.