Trends in myocardial infarction incidence and fatality in Warsaw Pol-MONICA population from 1984 to 1988

Abstract

Myocardial infarction attack rates and case fatality were analyzed between 1984–1988 in a population aged 25–64 inhabiting two districts of Warsaw and consisting of 133,000 men and 149,000 women. WHO MONICA methodology and diagnostic criteria were used. Within a 5-year period 3,595 men and 1,453 women were registered with AMI diagnosis (all MONICA diagnostic categories). Standardized myocardial infarction attack rates changed from 466 to 606/ 100,000 in men and from 178 to 267/100,000 in women respectively. The 5-year linear trends of attack rates were significant in all men aged 25–64 years (increase by 30%) and in men aged 25–34 and 55–64 years. In women these trends were not significant in all women as well as in particular 10-year age groups. Thirty percent of registered men and 20% of women died out of hospital. Total case fatality within 28 days since onset was equal to 43% in men and to 33% in women, showing no changes in men and decreasing slightly in women during the analyzed period. This, and comparable study conducted in 1971 in the Warsaw population, showed an almost 2-fold increase in the incidence of myocardial infarction. It is concluded that the increase in the incidence of AMI without a decrease in the fatality rate contributes substantially to the observed increase in premature ischemic heart disease mortality in the Warsaw population, especially in men.