Acute coronary events in some Dutch countryside communities

Incidence of, mortality from and fatality of acute myocardial infarction (AMI) and fatal attack of presumed coronary origin (FCA) were registered between July 1970 and March 1974 in a well-defined Dutch countryside population. Patients with a documented previous AMI or aged 70 or older were excluded. AMI (431 cases) and FCA (124 cases) were considered separately. No differences in coronary history profile, age or sex distribution could be demonstrated. However, the period of premonitory symptoms preceding FCA was at a 5% level significantly shorter than in AMI, provided that the unstable angina was the first symptom of IHD. The combined fatality rate of AMI and FCA, counting death during the first 28 days only, was 25% under age 55 and 32% in age group 55-69 yr. None of the 171 cases under age 55 who survived the first 24 h died in the following 4 weeks, whereas 20 out of 384 in the older age group did: a significant difference at a 5% level. The incidence and mortality rates are presented for both AMI and FCA, subdivided in the age groups 35-44, 45-54, 55-64, and 65-69, per 1000 person years. The incidence was 1, 5, 10, 14 in males, and 0, 1, 2, 6 in females, respectively. Mortality was 0, 1, 3, 5 in males, and 0, 0, 1, 3 in females. The set-up of the survey, the diagnostic criteria and the comparability with recent studies are discussed.