Trends in incidence and mortality from acute myocardial infarction in Nova Scotia and Saskatchewan 1974 to 1985. The Nova Scotia-Saskatchewan Cardiovascular Disease Epidemiology Group

Can J Cardiol. 1992 Apr;8(3):253-8.

Abstract

Objective: To compare trends in incidence and case fatality of acute myocardial infarction (AMI) in Nova Scotia and Saskatchewan, provinces with the highest and lowest rates, respectively.

Design: Provincial hospital separation files were linked with mortality files and searched to identify incident cases in 1977, 1981 and 1985. The diagnoses were validated on a random sample of hospital charts with discharge codes 410 and 411 to 414 of the International Classification of Diseases of the World Health Organization.

Results: In spite of persisting differences between Nova Scotia and Saskatchewan, standardized AMI mortality and incidence rates in males and females have decreased, although at a slower rate in Saskatchewan. In both provinces the greatest decrease has occurred in male deaths prior to any hospital admission--likely representing cases of sudden death. Excess mortality in Nova Scotia is due predominantly to out-of-hospital deaths. Case fatality rates have declined in both provinces. The proportion of definite and possible AMI was similar in Nova Scotia and Saskatchewan in 1977, but not thereafter.

Conclusions: Along with a decline in ischemic heart disease mortality, there appears to be a decline in AMI incidence in Nova Scotia. Parallel studies of risk factor changes, interventive care and access to care are required to explain the observed phenomena.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Incidence
  • Male
  • Medical Record Linkage
  • Middle Aged
  • Mortality / trends
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / mortality
  • Nova Scotia / epidemiology
  • Recurrence
  • Saskatchewan / epidemiology
  • Sex Factors