Key result
Between 2001 and 2009 in Norway, 28-day mortality after a first AMI was reduced annually by 3.8% overall (P<0.001), and 1-year all-cause mortality was reduced annually by 2.0% (P<0.001).
Cohort (n=115,608)
Yes
Effect estimate: 3.8% annual reduction (28-day mortality)
p-value: p=< 0.001
Between 2001 and 2009 in Norway, both 28-day and 1-year all-cause mortality after a first AMI declined significantly across all age groups and both sexes, driven by decreases in cardiovascular mortality.
Declining post-AMI mortality supports care advances; extends observational trends but leaves causal factors open for prospective study.
OBJECTIVE: The aim of this study was to investigate the trends in 28-day and 1-year mortality rates in patients hospitalized for a first acute myocardial infarction (AMI) in Norway during the period 2001-2009. Potential age group and gender differences in these trends were also examined. DESIGN, SUBJECTS AND SETTING: In this retrospective nationwide cohort study, patients hospitalized for a first AMI between 2001 and 2009 were identified in the Cardiovascular Disease in Norway 1994-2009 (CVDNOR) project and followed for 1 year. MAIN OUTCOME MEASURES: Trends in 28-day and 1-year mortality [both all-cause and cardiovascular disease (CVD) mortality] were investigated. RESULTS: A total of 115,608 patients (60.6% men) were hospitalized for a first AMI during the study period. Mortality at 28 days was reduced annually by 3.8% overall and by 6.7%, 4.1% and 2.6% in patients aged 25-64, 65-84 and ≥85 years, respectively (all Ptrend < 0.001). In addition, 1-year all-cause mortality was reduced annually by 2.0% overall (Ptrend < 0.001) and by 3.7% (Ptrend = 0.02), 2.5% (Ptrend < 0.001) and 1.1% (Ptrend < 0.001) in patients aged 25-64, 65-84 and ≥85 years, respectively. Furthermore, 1-year CVD mortality was reduced overall by 6.2% annually; a reduction was observed in all age groups. Finally, 1-year non-CVD mortality increased annually overall by 3.9% due to an increase in patients aged ≥65 years. CONCLUSION: Mortaity at 28 days after the first AMI declinedin Norway between 2001 and 2009 in both men and women and in all age groups. All-cause mortality at 1 year also declined both in men and women due to decreases in CVD mortality rates, whilst non-CVD mortality rates increased amongst patients ≥65 years of age.
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Sulo et al. (2014) conducted a cohort in first acute myocardial infarction (n=115,608). Time period (2001-2009) was evaluated on Trends in 28-day and 1-year mortality (all-cause and cardiovascular disease) (3.8% annual reduction (28-day mortality), p=< 0.001). Between 2001 and 2009 in Norway, 28-day mortality after a first AMI was reduced annually by 3.8% overall (P<0.001), and 1-year all-cause mortality was reduced annually by 2.0% (P<0.001).
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