Lack of improvement in five-year total mortality among patients with incident acute myocardial infarction: Data of the French southwestern MONICA registry

Background Acute myocardial infarction (AMI) management changes as guidelines evolve. The hypothesis of this study is that the survival of incident AMI should improve with time. Purpose The objective is to compare, according to the period of onset, the five-year total mortality in patients with incident AMI, supposing that mortality varies depending on the period considered and AMI management changed during these periods. Methods Data of the Haute-Garonne AMI registry was used to assess men and women (aged 35–74 years) who presented with AMI and who had no personal history of myocardial infarction or angina pectoris. Cases that happened between 1997 and 2005 were considered. The vital status five years after the event was assessed. Incidence rates of total mortality was expressed per 1000 person-year (with 95% confidence intervals). Total mortality was compared according to the period of onset (reference: 1997 to 1999/2000 to 2002/2003 to 2005) using sex-stratified Cox proportional hazards regression analyses adjusted for age. Results A total of 3924 incidents AMI were hospitalized between 1997 and 2012: 82.9% were men, median age at onset was 59.6 years old (58.2 and 66.7 years old, respectively for men and women). Among all incident cases of AMI, incidence rate of total mortality was 35.5 [95% CI: 32.8, 38.4] per 1000 person-year. Men and women rates were respectively: 35.2 [32.3, 38.4] and 37.2 [30.8, 44.9] per 1000 person-year. The incidence rates of total mortality by sex and year are shown in Fig. 1 . The results of the Cox analyses stratified by sex are presented in Table 1 . Conclusion Our study shows that the total mortality five years after an incident AMI does not vary significantly over time.