Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Fatalities from myocardial infarction in Nordic Countries and Lithuania
*National Public Health Institute Helsinki, Finland
Kalix Hospital Kalix, Sweden
Heart Preventive Clinic Reykjavik, Iceland
Institute of cardiology Kaunas, Lithuania
||Glostrup Population Studies Copenhagen, Denmark
¶Göteborg University Göteborg, Sweden
revised 14 June 1996; accepted 19 June 1996.
Correspondence: Dr Veikko Salomaa, National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
Abstract
Aim To investigate fatalities from myocardial infarction at 28 days and one-year among patients aged 35–64 years in the Nordic and Lithuanian centres participating in the World Health Organization MONICA (Monitoring of Trends and Determinants of Cardiovascular Disease) Project.
Methods and results Altogether 9100 myocardial infarction events registered according to the protocol of the MONICA Project were included in the study. For these events, one-year follow-up was carried out using routine mortality statistics. Fatalities were expressed as age standardized means per year for a 3-year period from the mid-1980s. The myocardial infarction fatalities at 28 days (including out-of-hospital deaths) in the eight participating populations varied among men, between 365% (95% confidence interval 32·6–40·4%) in Iceland and 54·6% (51·2–57·9%) in Kaunas, Lithuania. Among women, it varied from 32·4% (26·4–38·4) in Iceland to 57·5% (51·8–63·2%) in Glostrup, Denmark. More than half of this mortality occurred suddenly and the patient did not reach hospital alive. Fatalities for the period from day 28 to one year varied among men, from 5·3% (2·9–7·6%) in Iceland to 10·9% (8·0–13·8%) in North Karelia, Finland, and among women from 3·5% (0·4–6·5%) in Kuopio, Finland, to 13·5% (7·2–19·7%) in Glostrup, Denmark.
Conclusions Approximately half of the myocardial infarction patients died within one year after the onset of the attack and half of those who died, died out-of-hospital. While the myocardial infarction fatalities differed considerably between the participating populations, differences of this magnitude are unlikely to be totally explained by differences in the registration procedures. Further comparisons of acute coronary care and secondary prevention measures are warranted.
Key Words: Myocardial infarction • coronary heart disease • case-fatality • MONICA Project
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