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Acute MI deaths decreased by half during past decade in England
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Results from a study including more than 800,000 patients in England showed a decline in deaths from acute MI between 2002 and 2010, with decreased event rates and increased survival after MI accounting for slightly more than half of this decline.
Researchers obtained data from two national datasets, hospital episode statistics and mortality statistics on 840,175 patients admitted to the hospital for acute MI or who died suddenly from acute MI in England.
Overall, from 2002 to 2010, age standardized total mortality rate declined by about half, and event and case fatality rates both decreased by about one-third. Acute MI events declined at an average annual rate of 4.8% (95% CI, 3-6.5) in men and 4.5% (95% CI, 1.7-7.1) in women. Case fatality declined by 3.6% (95% CI, 3.4-3.7) in men and 4.2% (95% CI, 4-4.3) in women. Finally, total mortality declined by 8.6% (95% CI, 5.4-11.6) in men and 9.1% (95% CI, 4.5-13.6) in women.
In men, the age standardized mortality rate from acute MI decreased by 50%. Declines in event and case fatality rates accounted for 57% and 43% of this overall decrease, respectively. Similarly, mortality from acute MI decreased by 53% in women, with event and case fatality rates accounting for 52% and 48% of this overall decrease in acute MI mortality. However, study results showed that relative contributions differed by age, sex and geographical region and further research is needed.
In an accompanying editorial, Hugh Tunstall-Pedoe, MD, emeritus professor of cardiovascular epidemiology at the University of Dundee, United Kingdom, wrote that this decrease in acute MI has not occurred in all populations.
“As the world population ages and becomes more industrialized and urbanized, the decline in coronary mortality is predominately in rich nations, while rates increase in dozens of others,” Tunstall-Pedoe wrote. “Better data from countries where coronary disease is increasing are needed, but motivation and resources may be scarce.”
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Disclosure: The researchers report no relevant financial disclosures. Dr. Tunstall-Pedoe reports no relevant financial disclosures.
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