Recent time trends in acute myocardial infarction in Stockholm, Sweden

Aims: The purpose of this study was to analyse time trends in first acute myocardial infarction (AMI) incidence in Stockholm County during 1984–1996. Methods and results: The study base consisted of the population of Stockholm County 30–89 years old 1984–1996. New cases of first AMI in the study base were identified by combining information regarding hospital discharges and deaths. The diagnostic quality was evaluated for 2403 First-AMI cases 45–70 years old that occurred during 1992–1994. The evaluation indicated a very high agreement with diagnostic criteria of AMI among hospital treated cases. Among fatal cases outside hospital, the autopsy rate was nearly 70%. The incidence of first AMI declined during the study period for both men and women. In men, the age-adjusted incidence of first AMI was 18% lower in 1994–1996 than in 1984–1987 and in women it was 13% lower. The average yearly decline was 2% for men and 1.4% for women. Conclusion: The results of this study suggest a continued decline in AMI incidence in Stockholm. A reduction in the proportion of regular smokers has probably contributed to this decline. Future trends in AMI incidence are difficult to predict in view of diverging trends in risk factors.