Short-term and long-term case fatality in 11 878 patients hospitalized with a first acute myocardial infarction, 1979-2001: the Western Norway cardiovascular registry

Background Few studies have direct estimates of long-term survival after acute myocardial infarction (AM I). Our objective was to provide such estimates, and trends in these estimates, using data from a single hospital over a 23-year period. Design A retrospective cohort study. Methods We examined 28-day, 1-year and 10-year case fatality among 7635 men and 4243 women admitted to Haukeland University Hospital with a first AMI, during 1979-2001. Information on cardiovascular diagnoses and procedures were registered in the Western Norway Cardiovascular Registry, and data on deaths were obtained from the Cause of Death Registry, Statistics Norway. Results From 1979-1985 to 1994-2001, crude 28-day case fatality declined from 31.1 to 19.8% in men and from 373 to 26.8% in women (both, P-trend < 0.0001). Crude 10-year case fatality declined from 69.5-55.5% in men and from 80.8-66.1% in women (both, P-trend < 0.0001). Landmark analysis showed a decline in 1-10-year case fatality, among patients less than 60 years of age from 26.1 to 13.8% in men, and from 33.3 to 6.4% in women. In patients >= 60 years, the 28-day, 1-year and 10-year age-adjusted case-fatality rates were significantly lower in women than men. Conclusion Landmark analysis showed substantial improvement in up to 10 years survival after hospitalization for a first AMI. A significantly lower age-adjusted case fatality in women >= 60 years already after 28 days compared with men is specifically noticed. Eur J Cardiovasc Prev Rehabil 16:621-627 (C) 2009 The European Society of Cardiology