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Scandinavian Journal of Public Health
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Trends in event rates of first and recurrent, fatal and non-fatal acute myocardial infarction, and 28-day case fatality in the Northern Sweden MONICA area 1985 - 98

Torbjörn Messner

Department of Internal Medicine, Kiruna District Hospital, Kiruna, Sweden, torbjorn.messner{at}kiruna.se, Department of Public Health and Clinical Medicine, UmeÅ University Hospital, UmeÅ, Sweden

Vivan Lundberg

Department of Internal Medicine, Kalix District Hospital, Kalix, Sweden, Department of Public Health and Clinical Medicine, UmeÅ University Hospital, UmeÅ, Sweden

Stina Boström

Department of Internal Medicine, Kalix District Hospital, Kalix, Sweden

Fritz Huhtasaari

Department of Internal Medicine, Sunderby Hospital, LuleÅ, Sweden

Bo Wikström

Department of Internal Medicine, Kalix District Hospital, Kalix, Sweden

Aims: This study looks at trends in event rates of first and recurrent fatal and non-fatal acute myocardial infarction (AMI), and 28-day case fatality in AMI within the Northern Sweden MONICA area. Methods: The AMI event rate and 28-day case fatality in acute myocardial infarction were registered between 1985 and 1998 in the two northernmost counties in Sweden in men and women in the age groups 25 - 64 years. Results: Statistically significant mean annual decreases were found in fatal and non-fatal combined event rates (4% for men and 2.3% for women), fatal event rate (7.1% for men and 5% for women), fatal first acute myocardial infarction (7.1% for men and 4.4% for women), and both non-fatal and fatal recurrent AMI for both sexes (5.5% for both men and women for non-fatal and, for fatal AMI, 7.1% for men and 5.7% for women). In addition, there were significant decreases for men in non-fatal event rate (2.4%), and non-fatal first AMI (1.4%). The decreases in case fatality were small, especially so for women. Conclusions: There is a trend of decreasing event rates in both fatal and non-fatal AMI, and first and recurrent AMI, most pronounced for men. The case fatality also decreased although to a lesser degree, suggesting that the decreasing mortality in ischaemic heart disease mainly is caused by reduced disease incidence.

Key Words: acute myocardial infarction • case fatality • fatal • MONICA • non-fatal • trend

Scandinavian Journal of Public Health, Vol. 31, No. 61 suppl, 51-59 (2003)
DOI: 10.1080/14034950310001388
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