Myocardial Infarction in Malmö 1960–1968

Abstract Malmö is unusually well suited for studies on the frequency of a disease since the whole population of about a quarter of a million inhabitants is served by a single hospital. The case records from the Department of Medicine were perused and those with a definite diagnosis of acute myocardial infarction (AMI) were collected. The hospital material comprised 3 249 patients with a mean age at onset of 67 years (65 years for the 2 166 males and 72 for the 1 083 females). The incidence was found to increase with age, the rise being more pronounced in the higher than in the lower decades. There was an overrepresentation of patients with diabetes mellitus, and mortality was higher among these patients than in the whole hospital material. The hospital mortality for AMI was 33.1%, 30.4 for men and 38.5 for women, the latter higher figure being due to the higher mean age of the women. Rather pronounced yearly differences in mortality were observed, with a low of 27.9% in 1964 and a high of 38.9% in 1966. Thirty‐five per cent of the patients arrived at the hospital within 3 hours after onset of symptoms, but the mean delay was 31 hours. The mortality figure of 33.1% is misleadingly low because many patients die before they reach hospital. Including patients who died at home and were autopsied in the Department of Forensic Medicine, and those who were dead on arrival at the hospital, the mortality rose to 43%. The importance of preventive measures as a complement to the coronary care units is stressed.