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Significant decline in case fatality after acute myocardial infarction in Denmark--a population-based study from 1994
Steen Z Abildstrom1, Søren Rasmussen, Mette Madsen
1National Institute of Public Health, Copenhagen, Denmark. sza@niph@dk
Objective:
We evaluated trends in in-hospital case fatality after acute myocardial infarction (AMI) in Denmark and analysed changes in the hospitalization rate for AMI.
Design:
National population-based registries were used to identify patients (> or =30 years) who were admitted for their first AMI from 1994 to 2001.
Results:
The annual relative decline in case-fatality rate was constant at 10.5% (95% confidence interval (CI) 9.5-11.5%). The decline was similar for both genders at all ages. The hospitalization rate decreased from 1994 to 1999 at an annual average of 4.3% (95% CI 3.4-5.1%). In 2000 and 2001 the average annual increase was 7-8%.
Conclusion:
The case-fatality rate after AMI declined significantly in Denmark, similar to other Western countries, but the level is still higher than that of the USA. The increasing hospitalization rate coincided with changes in risk factors in the general population. However, the influence of introducing troponins in the diagnosis of AMI and diagnosis-related grouping may in particular account for the increased hospitalization rate.