Statistics on mortality following acute myocardial infarction in 842,897 Europeans.
2019-07-30T13:59:40Z (GMT) by
AIMS: To compare ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) mortality between Sweden and the UK, adjusting for background population rates of expected death, case mix and treatments. METHODS AND RESULTS: National data were collected from hospitals in Sweden (n = 73 hospitals, 180,368 patients, Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies [SWEDEHEART]) and the UK (n = 247, 662,529 patients, Myocardial Ischaemia National Audit Project [MINAP]) between 2003 and 2013. There were lower rates of revascularisation [STEMI (43.8% vs. 74.9%); NSTEMI (27.5% vs 43.6%)] and pharmacotherapies at time of hospital discharge including [aspirin (82.9% vs. 90.2%) and (79.9% vs. 88.0%), β-blockers (73.4% vs. 86.4%) and (65.3% vs. 85.1%)] in the UK compared with Sweden, respectively. Standardised net probability of death (NPD) between admission and 1 month was higher in the UK for STEMI (8.0 [95% confidence interval 7.4-8.5] vs. 6.7 [6.5-6.9]) and NSTEMI (6.8 [6.4-7.2] vs. 4.9 [4.7-5.0]). Between 6 months and 1 year and more than 1 year, NPD remained higher in the UK for NSTEMI (2.9 [2.5-3.3] vs. 2.3 [2.2-2.5]) and (21.4 [20.0-22.8] vs. 18.3 [17.6-19.0]), but was similar for STEMI (0.7 [0.4-1.0] vs. 0.9 [0.7-1.0]) and (8.4 [6.7-10.1] vs. 8.3 [7.5-9.1]). CONCLUSION: Short-term mortality following STEMI and NSTEMI was higher in the UK compared with Sweden. Mid- and longer-term mortality remained higher in the UK for NSTEMI, but was similar for STEMI.Differences in mortality may be due to differential use of guideline-indicated treatments.