The mortality and case fatality rates in acute myocardial infarction in Finland. The results of Helsinki Coronary Register during 1970–1977

In 1970 the Helsinki Coronary Register gathered data on 1191 AMI cases and 470 deaths from AMI of Helsinki residents under 65 years of age. Since then the mortality (deaths within the first 28 days per 1000 habitants of Helsinki) from AMI declined by 1.8% a year during the period 1970–1977, and there were no statistically significant differences in trends between women and men, or between different age groups (P>0.10). The case fatality rate varied from 39% in 1970 to 35% in 1977, and the statistical analysis could not reveal any significant permanent decreasing trend in any age or sex group. These results, together with our previously reported AMI incidence trends, show that at least in 1970–1977 the declining trend in mortality from AMI was due to an equal fall in the incidence of AMI. Therefore there is reason to think that the effect is due to the prevention of AMI, rather than to more effective acute care.