title: Acute myocardial infarction mortality in Cuba, 1999-2008.
abstract: Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years.
  
  
  
  Describe acute myocardial infarction mortality in Cuba from 1999 through 2008.
  
  
  
  A descriptive study was conducted of persons aged ≥25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room) and location (jurisdiction) of death. Proportions, age- and sex-specific rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two five-year time frames within the study period.
  
  
  
  A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51.8% (55.1% in 1999-2003 and 49.7% in 2004-2008). In the first five-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged ≥75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both five-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively).
  
  
  
  Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies, studies of out-of-hospital mortality and quality of care assessments for these patients.
authors.affiliation: Cardiology and Cardiovascular Surgery Institute, Havana, Cuba. nurysarmas@infomed.sld.cu
authors.forename: Nurys B
authors.initials: NB
authors.lastname: Armas
authors.forename: Yanela Y
authors.initials: YY
authors.lastname: Ortega
authors.forename: Reinaldo
authors.initials: R
authors.lastname: de la Noval
authors.forename: Ramón
authors.initials: R
authors.lastname: Suárez
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Llerena
authors.forename: Alfredo F
authors.initials: AF
authors.lastname: Dueñas
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003462:Cuba / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality*; D011159:Population Surveillance; D012042:Registries; D017678:Sex Distribution