Increasing trends of acute myocardial infarction in Spain: the MONICA-Catalonia Study

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Abstract
Aims To assess coronary mortality and morbidity secular trends in Spain. Methods and results Acute coronary events occurring in both sexes at ages 35–74 years between 1985 and 1997, were monitored in a geographical area of Catalonia, through a population-based registry. Information was collected from annual discharge lists of 78 hospitals and from death certificates, and validated following the methods and quality control of the World Health Organization MONItoring Trends and Determinants in CArdiovascular Disease Project (MONICA). Registration included 19 119 valid events (14 221 in men, 4898 in women) of which 30% were fatal and 41% were definite acute myocardial infarctions. Average attack rates were 315 per 100 000 (95% CI 300–329) and 80 (75–86) in men and women, respectively. Incidence (first-ever event) rates were 209 (194–224) and 56 (52–60) per 100 000. Attack rates increased annually by 2.1% (0.3–4.1) and 1.8% (−0.9 to +4.6). Average 28-day case fatality was 46% (44–47) in men decreasing significantly by 1.4 and 53% (51–55) in women with no change. Fatal trends remained stable. Nationwide morbidity statistics showed similar trends. Conclusion Acute coronary syndromes are rising in Spanish men.

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