ABSTRACT
There has been a large amount of progress in the methods of prevention and treatment of ischaemic heart disease (IHD), but the effect of these changes on mortality due to IHD has not been assessed. This paper presents the complex analysis of 10-year trends of incidence, case fatality and mortality due to myocardial infarction (MI) and changes in medical care in the acute phase of MI in residents of one province of Poland-Tarnobrzeg Voivodship, which was the target population of the POL-MONICA Kraków Project (over 280,000 men and women at age 25-64 years). In men, the incidence of MI, which was 335/100,000 in 1984, increased in 1986 to 463/1,000,000 and then was stable until 1993 when it felt to 362/100,000. Mortality from MI, which was 149/100,000 in 1984, increased to 212/100,000 in 1986 and then was stable until 1992, before falling to 173/100,000 in 1993. There were large fluctuations in the incidence and mortality from MI in women i.e. from 58/100,000 to 116/100,000 and from 21/100,000 to 55/100,000 respectively. In 1993 the incidence was 82/100,000 and mortality was 32/100,000. After adding sudden deaths and other fatal events attributed to IHD the mortality figures increased over the ten years of observation by an average of 29% in men and by 28% in women. The average total MI case fatality was 47% in men and 40% in women, with 86% of all deaths due to MI occurring out of hospital. Case-fatality of MI managed in hospital was 11% on average.
