title: [Analysis of trends in myocardial infarction case-fatality, incidence and mortality rates in Girona, Spain, 1990-1999].
abstract: OBJECTIVE
  The incidence of myocardial infarction in Spain is low, and mortality has been decreasing over the last few decades. The objective of this study was to analyze trends in myocardial infarction mortality, incidence, attack rates, and 28-day case-fatality attack rates between 1990 and 1999 in the general population aged 35-74 years in Girona, Spain.
  
  
  METHODS
  The study included all myocardial infarction cases in Girona classified according to the MONICA algorithm. Attack, incidence, mortality rates and case-fatality were calculated. In addition, the annual percentage change in each of these indicators during the study period was also calculated.
  
  
  RESULTS
  The mean attack rate per 100,000 inhabitants was 258 (95% CI, 249-267) in men and 55 (95% CI, 51-59) in women. The mean mortality rate per 100,000 was 99 (95% CI, 93-104) in men and 25 (95% CI, 22-28) in women. Significant reductions in attack, incidence and recurrence rates were observed in men aged 35-64 years during the period 1990-1999, but not in men aged 65-74 years, nor in women.
  
  
  CONCLUSIONS
  Myocardial infarction incidence and mortality rates were low in the general population aged 35-64 years. Rates improved in men aged 35-64 years during the period 1990-1999, but not in those aged 65-74 years, which indicates that a combination of primary and secondary prevention has increased the age at which a myocardial infarction or its recurrence is observed. Rates in woman were lower and did not change during the study period.
authors.affiliation: Unidad de Lípidos y Epidemiología Cardiovascular, Instituto Municipal de Investigación Médica y Hospital del Mar, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Gil
authors.forename: Helena
authors.initials: H
authors.lastname: Martí
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosúa
authors.forename: María
authors.initials: M
authors.lastname: Grau
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.forename: Rafael
authors.initials: R
authors.lastname: Masiá
authors.forename: Gloria
authors.initials: G
authors.lastname: Pérez
authors.forename: Pere
authors.initials: P
authors.lastname: Roset
authors.forename: Oscar
authors.initials: O
authors.lastname: Bielsa
authors.forename: Joan
authors.initials: J
authors.lastname: Vila
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology