The case-fatality after acute myocardial infarction among Lithuanian urban adults from 2000 to 2023

Background Over the past two decades, 28‑day acute myocardial infarction (AMI) case‑fatality (CF) rates have declined globally due to improved treatment and secondary prevention. This study aimed to evaluate AMI CF levels and trends in the Kaunas population aged 25–64 from 2000 to 2023. Methods Data were obtained from the population‑based Kaunas Ischemic Heart Disease Registry, operating under the WHO MONICA standards. The study included adults with AMI or coronary heart disease death registered within 28 days of the onset of AMI. CF was defined as the proportion of AMI deaths among all AMI cases. Trends were assessed using JoinPoint regression. Results From 2000 to 2023, 28‑day AMI CF in males showed no significant change, while in females it increased by 2.5% per year (p = 0.002). In‑hospital AMI CF remained stable in both sexes. Males had higher average AMI CF rates than females in both age groups (25–54 and 55–64). Only females aged 55–64 showed a significant rise in AMI CF (3.0%/year, p = 0.002). A trend change point was identified in 2006 for males (no significant trend) and in 2010 for females, after which the AMI CF rates increased. Among males, in‑hospital AMI CF decreased significantly from 2015 to 2023 (14.7%/year). Conclusions Over the two decades, 28‑day AMI CF among 25-64-year-old persons remained unchanged in males but increased in females. In‑hospital AMI CF showed no major change in either sex. Males consistently had higher AMI CF rates as age increased. While aging did not affect AMI CF trends in males, rates rose significantly among older females. Key messages • In Lithuania, over the past two decades, 28‑day acute myocardial infarction case-fatality among 25-64-year-old persons remained unchanged in males but increased in females. • In Lithuania, males consistently had higher acute myocardial infarction case-fatality rates with age.