Trends of 28 days case fatality rate after first acute myocardial infarction in Isfahan, Iran, from 2000 to 2009

Background: the purpose of the present study was the analysis of the trends in case fatalityrate of acute myocardial infarction (ami) in isfahan, iran. this analysis was performed based ongender, age groups, and type of ami according to the international classification of diseases,version 10, during 2000-2009.methods: disregarding the multinational monitoring of trends and determinants incardiovascular disease (monica), this cohort study considered all ami events registeredbetween 2000 and 2009 in 13 hospitals in isfahan. all patients were followed for 28 days. inorder to assess the case fatality rate, the kaplan-meier analysis, and to compare survival rate,log-rank test were used. using the cox regression model, 28 days case fatality hazard ratio (hr)was calculated.results: in total, 12,900 patients with first ami were entered into the study. among them,9307 (72.10%) were men and 3593 (27.90%) women. the mean age in all patients increasedfrom 61.36 ± 12.19 in 2000-2001 to 62.15 ± 12.74 in 2008-2009, (p = 0.0070); in women, from65.38 ± 10.95 to 67.15 ± 11.72 (p = 0.0200), and in men, from 59.75 ± 12.29 to 59.84 ± 12.54(p = 0.0170),. in addition, the 28 days case fatality rate in 2000-2009 had a steady descendingtrend. thus, it decreased from 11.20% in 2000-2001 to 07.90% in 2008-2009; in men, from09.20% to 06.70%, and in women, from 16.10% to 10.90%. during the study, hr of case fatalityrate in 2000-2001 declined; therefore, in 2002-2003, it was 0.93 [95% confidence interval(ci) = 0.77-1.11], in 2004-2005, 0.88 (95% ci = 0.73-1.04), in 2006-2007, 0.67 (95% ci = 0.56-0.82), and in 2008-2009, 0.69 (95% ci = 0.56-0.82).conclusion: in isfahan, a reduction was observable in the trend of case fatality rate in bothgenders and all age groups. thus, there was a 29.46% reduction in case fatality rate (27.17% inmen, 32.29% in women) during the study period.