Outcomes of acute myocardial infarction in Canada.
BACKGROUND
Little information is available on recent population-based trends in the outcomes of patients who have had an acute myocardial infarction (AMI) in Canada.


METHODS
Data were analyzed from the Discharge Abstract Database and Hospital Morbidity Database of the Canadian Institute for Health Information. All new cases of AMI in Canada between fiscal 1997/98 and fiscal 1999/2000 of patients at least 20 years old were examined. Data were also analyzed from these databases for hospital readmissions for a second AMI, angina and congestive heart failure (CHF).


RESULTS
There were 139,523 new AMI cases. The overall crude in-hospital AMI mortality rate in Canada was 12.3%. In-hospital mortality rate after an AMI was worse for women than for men in Canada (16.7% and 9.9%, respectively). The age- and sex-standardized in-hospital mortality rate varied from a low of 10.5% (95% CI 8.4% to 12.6%) in Prince Edward Island to a high of 13.1% (95% CI 12.8% to 13.5%) in Quebec. Among AMI survivors, 12.5% were readmitted within one year for angina, 7.7% for a second AMI and 7.5% for CHF. There were wide interregional differences in age- and sex-standardized mortality rates and one-year readmission rates.


CONCLUSIONS
AMI is associated with a substantial acute mortality rate in Canada, especially in the elderly and female patients. Identifying the causes of interregional differences in patient outcomes should be a priority for future research.
Tu
Jack V
JV
Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada. tu@ices.on.ca
Austin
Peter C
PC
Filate
Woganee A
WA
Johansen
Helen L
HL
Brien
Susan E
SE
Pilote
Louise
L
Alter
David A
DA
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000453:epidemiology / Q000628:therapy; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000208:ethnology; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D010359:Patient Readmission; D011787:Quality of Health Care; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology