Key result
Hospital death with autopsy linked to ~46-fold higher odds of MI certification among IHD deaths.
Why the study?
Considerable variation exists in myocardial infarction mortality rates across high-income countries, some of which may be artefactual.
Observational (n=7,068,211)
Effect estimate: OR 46.49 (95% CI 46.02-46.96)
Absolute Event Rate: 43.8% vs 1.6%
Significant international variation in MI mortality rates may be largely artefactual, driven by differences in how certifying physicians interpret and apply diagnostic criteria for out-of-hospital deaths.
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MI mortality comparisons across countries warrant caution due to certification differences; leaves open whether observed variations reflect true incidence.
Timonin et al. (2021) conducted an observational in Ischaemic heart disease (IHD) mortality (n=7,068,211). Death in hospital with autopsy (Russia) vs. Death out of hospital without autopsy (Russia) was evaluated on Myocardial infarction specified as the underlying cause among all deaths from ischaemic heart disease (OR 46.49, 95% CI 46.02-46.96). Hospital death with autopsy in Russia increased the odds of an ischaemic heart disease death being certified as myocardial infarction (OR 46.49) compared to out-of-hospital death without autopsy.
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