Article Text


Chronic disease
P2-333 Acute myocardial infarction: incidence and 30-day case fatality in England for first and recurrent events
  1. K Smolina,
  2. M Goldacre,
  3. L Wright,
  4. M Rayner
  1. University of Oxford, Oxford, UK


Introduction There are several population-based English studies of AMI, but they are local rather than national, do not necessarily distinguish first events and re-infarctions, and are out of date. Our objective was to study AMI incidence and 30-day case fatality rates (CFRs) for first and recurrent events in England in 2007 (population 51.8 million).

Methods Analysis of linked routine national hospital and mortality data, with an 8-year washout period to identify people who already had a prior event, in order to distinguish whether each AMI in 2007 was first or recurrent.

Results Of 88 311 AMI events in 2007, 86% were first events. Age-standardised incidence of first AMI (per 100 000 person years) was 151 (150–152) in men and 64 (63–65) in women. Age-standardised 30-day overall CFRs including sudden deaths without hospitalisation for first AMI were 35.5% (35.1–36.0) and 34.4% (33.3–35.4) in men and 34.4% (33.9–35.0) and 31.0% (29.8–32.3) in women, for first AMIs and re-infarctions, respectively. Age-standardised 30-day hospitalised CFRs were much lower at 14.5% (14.1–14.9) and 14.1% (13.2–15.0) in men and 15.2% (14.7–15.7) and 13.9% (12.8–15.0) in women for first AMIs and re-infarctions, respectively.

Conclusions This study provides, for the first time, total national-level population-based estimates of first and recurrent AMI as well as overall AMI incidence and case fatality in England. It holds informative value in better understanding AMI epidemiology and prognosis that should prove useful to practitioners and policy makers.

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