Analysis of trends in myocardial infarction case-fatality, incidence and mortality rates in Girona, Spain, 1990-1999

Introduction and objectives. The incidence of myocardial infarction in Spain is low, and mortality has been decreasing over the last few decades. The objective of this study was to analyze trends in myocardial infarction mortality, incidence, attack rates, and 28-day case-fatality attack rates between 1990 and 1999 in the general population aged 35-74 years in Girona, Spain. Methods. The study included all myocardial infarction cases in Girona classified according to the MONICA algorithm. Attack, incidence, mortality rates and case-fatality were calculated. In addition, the annual percentage change in each of these indicators during the study period was also calculated. Results. The mean attack rate per 100,000 inhabitants was 258 (95% Cl, 249-267) in men and 55 (95% Cl, 5159) in women. The mean mortality rate per 100,000 was 99 (95% Cl, 93-104) in men and 25 (95% Cl, 22-28) in women. Significant reductions in attack, incidence and recurrence rates were observed in men aged 35-64 years during the period 1990-1999, but not in men aged 65-74 years, nor in women. Conclusions. Myocardial infarction incidence and mortality rates were low in the general population aged 35-64 years. Rates improved in men aged 35-64 years during the period 1990-1999, but not in those aged 65-74 years, which indicates that a combination of primary and secondary prevention has increased the age at which a myocardial infarction or its recurrence is observed. Rates in woman were lower and did not change during the study period.