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
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