Myocardial Infarction Surveillance in a Metropolitan Community

This project was designed to test the feasibility and practicability of continuous surveillance of cases of myocardial infarction in hospitalized patients in a large metropolitan community. Twenty-three hospitals regularly report myocardial infarction cases when the patient is discharged to the Seattle-King County Health Department. A 25% sample of the first year's cases indicated verifiable diagnoses in at least 85% of cases. Case reporting, checked against diagnostic indices in each hospital, was remarkably complete over a 12-month period spanning one half of each of two surveillance years. Approximately 1,500 cases were reported for each of two years; approximately 80% were first attacks. Incidence of hospitalization for myocardial infarction was 403 per 100,000 for men and 192 per 100,000 for women (age 30 and over). Case fatality rates remained under 20% for both men and women until 60 years of age, after which time they increased progressively.