Constituent country inequalities in myocardial infarction incidence and case fatality in men and women in the United Kingdom, 1996-2005.
BACKGROUND
Understanding myocardial infarction (MI) incidence and case fatality trends across the four UK constituent countries is of importance following devolution of the government of health-care services.


METHODS
Retrospective cohort study using a primary care database (5.19 million patients) examining trends in incidence of first MI and 30-day case fatality.


RESULTS
From 1996 to 2005, the incidence of MI decreased in all countries, but reductions were greater in England (men, -3.1%; women, -2.8%) and Wales (men, -3.3%; women, -4.6%) than in Scotland (men, -1.9%; women, -0.6%) and Northern Ireland (men no change, women, -0.8%) (average annual percentage change). Greater reductions in England and Wales than Scotland and Northern Ireland meant a widening of north-south difference in MI incidence over the study period. Downward trends in 30-day case fatality were found in each country but less regional variation was evident (England men, -12.0%, women, -11.0%; Wales men, -18.4%, women, -12.6%; Scotland men, -9.5%, women, -9.0%; Northern Ireland men, -8.6%, women, -13.0%).


CONCLUSIONS
From 1996 to 2005, downward trends in the incidence of first MI and 30-day case fatality were evident in each constituent country. Greater improvements in case fatality, compared with incidence, were found within each country.
Davies
A R
AR
Centre for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. alisha.davies@nhs.net
Grundy
E
E
Nitsch
D
D
Smeeth
L
L
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D004739:England / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D009660:Northern Ireland / Q000453:epidemiology; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D013223:Statistics as Topic; D014852:Wales / Q000453:epidemiology