Incidence of acute myocardial infarction in the Republic of Serbia from 2006 to 2022

Introduction/Aim: Cardiovascular diseases represent the leading cause of mortality worldwide and were responsible for more than 19.8 million deaths in 2022, accounting for 32% of all deaths according to World Health Organization data. Of all deaths due to cardiovascular diseases, as many as 85% were caused by acute myocardial infarction and stroke. The highest number of deaths occurs in countries with low and middle incomes. The aim of this study was to analyze trends in the incidence of acute myocardial infarction in the Republic of Serbia from 2006 to 2022.Methods: Data on newly diagnosed cases of acute myocardial infarction for the period 2006-2022 were obtained from the National Registry for Acute Coronary Syndrome, maintained by the Institute of Public Health of Serbia "Dr Milan Jovanović Batut", as well as from official Health Statistical Yearbooks of the Republic of Serbia for the observed period. Crude incidence rates (CR) and age-standardized incidence rates adjusted to the European and world standard populations (ASR-E and ASR-W) were analyzed.Results: During the observed period, a decline in age-standardized incidence rates adjusted to the European standard population (ASR-E: 170.9 → 147.4) and to the world standard population (ASR-W: 118.2 → 101.8 per 100,000 population) was observed. Incidence rates varied over time, with the highest age-standardized incidence rate adjusted to the European standard population recorded in 2009 (183.7 per 100,000), and the lowest in 2017 (132.3 per 100,000) (Figure 1). The highest age-standardized incidence rate adjusted to the world standard population ranged from 126.1 per 100,000 in 2009 to 91.0 per 100,000 in 2017.Conclusion: The reduction in age-standardized incidence rates of acute myocardial infarction in the Republic of Serbia from 2006 to 2022 is likely the result of improved control of cardiovascular risk factors, including wider use of statins and modern antihypertensive therapies in primary and secondary prevention, as well as the effectiveness of national preventive programs such as public education on symptom recognition, healthy diet and physical activity, and smoking cessation campaigns. In addition, the development of networks of catheterization laboratories for emergency interventions in Serbia has enabled faster patient management, thereby influencing clinical outcomes and the incidence of recurrent myocardial infarction.