[Myocardial infarction. Population case-fatality in seven Spanish autonomous communities: the IBERICA Study].

Abstract

BACKGROUND AND OBJECTIVE:

The magnitude of the problem of myocardial infarction (MI) is better understood by assessing the population case-fatality than by analyzing only the number of patients attending hospitals.

PATIENTS AND METHOD:

Our data come from the IBERICA Study (Investigation, Specific Search and Registry of Acute Myocardial Ischemic Syndrome). Twenty eight-day MI population case-fatality is described in the population aged 25 to 74 years during 1997 and 1998 in the following Spanish autonomous communities: Castilla-La Mancha (Toledo and Albacete), Catalonia (Girona), Valencia Community (Valencia), Balearic Islands (Majorca), Murcia, Navarra and Basque Country. The relationship between case-fatality and other variables such as sex, age and geographic area is also analyzed.

RESULTS:

A total of 10,660 MI cases were registered, 4,106 of whom died within the period of 28 days following the onset of symptoms (38.5%; CI 95%, 37.6-39.4%). The overall case-fatality was 37.0% (CI 95%, 35.9-38.0%) in men and 44.3% (CI 95%, 42.3-46.4%) in women. Death occurred out of hospitals in 2,869 (69.9%) cases. An increased case-fatality in women was associated with a higher in-hospital case-fatality (45% higher than men). The proportion of patients who died before reaching a hospital was similar in both genders. Classical symptoms of MI were more common among men than women (82.7% vs. 77.6%, p < 0,001). The interval between symptoms' onset and hospitalization was 30 minute longer among hospitalized women as compared with men (p < 0,001).

CONCLUSIONS:

Population MI case-fatality is high in the seven Spanish autonomous communities studied. Approximately 2 out of 3 deaths occur without patients being able to reach a hospital. These results emphasize the importance of primary and secondary prevention measures and the necessity to design ready-access systems to defibrillation and resuscitation manoeuvres for patients with cardiopulmonary arrest.

• Authors: José García, Roberto Elosua, María José Tormo Díaz, Covadonga Audicana Uriarte, Oscar Zurriaga, Antonio Segura, Miquel Fiol, Concepción Moreno-Iribas, Eva Alonso, Susana Bosch, Gemma Vega, Joan Sala, Jaume Marrugat
• Journal: Medicina clinica (Med Clin (Barc)) Vol. 121 Issue 16 Pg. 606-12 (Nov 08 2003) ISSN: 0025-7753 [Print] Spain
• Vernacular Title: Mortalidad poblacional por infarto agudo de miocardio. Estudio IBERICA.
• PMID: 14636534 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (mortality)
• Risk Factors