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Time trends in survival from myocardial infarction in Stockholm County 1976-1984
N Hammar1, F F Larsen, E Sandberg
1Department of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Abstract:
In Stockholm county, a rapid decline in mortality from acute myocardial infarction (AMI) was observed among middle-aged men in the early 1980s. In the present study survival among AMI patients from 1976 to 1984 was investigated in order to explore whether improvements in survival may have contributed to this decline. AMI patients aged 30-74 years (n = 16,108) were identified through a hospital discharge register. Deaths within one year of hospital admission were ascertained by means of linkage to the national cause of death register. Survival 1 year after hospital admission increased in both genders during the period 1981-1984, but among women there was no uniform trend over the whole study period. The estimated age-adjusted relative risk of death within one year after hospital admission for patients with a first infarction admitted to hospital in 1983-1984 as compared to in 1981-1982 was 0.88 for men and 0.79 for women. The causes of the observed increase in survival could not be determined from this study, but changes in medical intervention as well as diagnostic improvements may have been important. Improved survival may have contributed to about 30% of the decline in mortality from AMI among middle-aged men in Stockholm county during the early 1980s.
Insights
Improved survival rates for acute myocardial infarction (AMI) patients in Stockholm contributed to a 30% decline in male mortality during the early 1980s. This study investigated survival trends in AMI patients from 1976-1984.
Area of Science:
- Cardiology
- Public Health
Background:
- Stockholm county observed a rapid decline in middle-aged men's mortality from acute myocardial infarction (AMI) in the early 1980s.
- The contribution of improved patient survival to this mortality decline was previously unclear.
Purpose of the Study:
- To investigate survival trends among acute myocardial infarction (AMI) patients between 1976 and 1984.
- To determine if enhanced survival rates among AMI patients influenced the observed decrease in mortality.
Main Methods:
- Identified 16,108 AMI patients aged 30-74 years using a hospital discharge register.
- Ascertained one-year mortality through linkage with the national cause of death register.
- Analyzed age-adjusted relative risk of death for patients admitted in 1983-1984 versus 1981-1982.
Main Results:
- One-year survival post-hospital admission improved for both genders between 1981-1984.
- The relative risk of one-year mortality decreased significantly for men (0.88) and women (0.79) admitted in 1983-1984 compared to 1981-1982.
- Improved survival accounted for approximately 30% of the decline in AMI mortality among middle-aged men.
Conclusions:
- Enhanced survival rates among acute myocardial infarction patients likely contributed to the reduction in mortality.
- Potential factors include advancements in medical interventions and diagnostic capabilities.
- Further research is needed to pinpoint the exact causes of improved survival.