Trends of ۲۸ days case fatality rate after first acute myocardial infarction in Isfahan, Iran, from ۲۰۰۰ to ۲۰۰۹

BACKGROUND: The purpose of the present study was the analysis of the trends in case fatality rate of acute myocardial infarction (AMI) in Isfahan, Iran. This analysis was performed based on gender, age groups, and type of AMI according to the International Classification of Diseases, version ۱۰, during ۲۰۰۰-۲۰۰۹. METHODS: Disregarding the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA), this cohort study considered all AMI events registered between ۲۰۰۰ and ۲۰۰۹ in ۱۳ hospitals in Isfahan. All patients were followed for ۲۸ days. In order to assess the case fatality rate, the Kaplan-Meier analysis, and to compare survival rate, log-rank test were used. Using the Cox regression model, ۲۸ days case fatality hazard ratio (HR) was calculated. RESULTS: In total, ۱۲,۹۰۰ patients with first AMI were entered into the study. Among them, ۹۳۰۷ (۷۲.۱۰%) were men and ۳۵۹۳ (۲۷.۹۰%) women. The mean age in all patients increased from ۶۱.۳۶ ± ۱۲.۱۹ in ۲۰۰۰-۲۰۰۱ to ۶۲.۱۵ ± ۱۲.۷۴ in ۲۰۰۸-۲۰۰۹, (P = ۰.۰۰۷۰); in women, from ۶۵.۳۸ ± ۱۰.۹۵ to ۶۷.۱۵ ± ۱۱.۷۲ (P = ۰.۰۲۰۰), and in men, from ۵۹.۷۵ ± ۱۲.۲۹ to ۵۹.۸۴ ± ۱۲.۵۴ (P = ۰.۰۱۷۰),. In addition, the ۲۸ days case fatality rate in ۲۰۰۰-۲۰۰۹ had a steady descending trend. Thus, it decreased from ۱۱.۲۰% in ۲۰۰۰-۲۰۰۱ to ۰۷.۹۰% in ۲۰۰۸-۲۰۰۹; in men, from ۰۹.۲۰% to ۰۶.۷۰%, and in women, from ۱۶.۱۰% to ۱۰.۹۰%. During the study, HR of case fatality rate in ۲۰۰۰-۲۰۰۱ declined; therefore, in ۲۰۰۲-۲۰۰۳, it was ۰.۹۳ [۹۵% confidence interval (CI) = ۰.۷۷-۱.۱۱], in ۲۰۰۴-۲۰۰۵, ۰.۸۸ (۹۵% CI = ۰.۷۳-۱.۰۴), in ۲۰۰۶-۲۰۰۷, ۰.۶۷ (۹۵% CI = ۰.۵۶-۰.۸۲), and in ۲۰۰۸-۲۰۰۹, ۰.۶۹ (۹۵% CI = ۰.۵۶-۰.۸۲). CONCLUSION: In Isfahan, a reduction was observable in the trend of case fatality rate in both genders and all age groups. Thus, there was a ۲۹.۴۶% reduction in case fatality rate (۲۷.۱۷% in men, ۳۲.۲۹% in women) during the study period. 

Keywords:

Case Fatality Rate , Myocardial Infarction , Trend , Iran