Objectives: To study the incidence of first acute myocardial infarction (AMi) in the Netherlands.
Background: We recently showed that AMi patients can be followed longitudinally within dutch national medical registrations in a valid way. This makes it possible to provide nationwide incidence estimates of first AMi in the Netherlands.
Methods: New cases of first AMi in the dutch population in 2000 were identified through linkage of the national hospital discharge register, the population register and the cause of death statistics and included hospitalised first Ami patients and out-of-hospital deaths from first AMi.
Results: 31,777 patients with a first AMi were identified. The incidence (per 100,000 persons per year) increased from 2 in men aged <30 years to 2996 in men aged > or = 90 years. Corresponding figures for women ranged from 1 to 2226. The incidence was higher in men than in women in all age groups, but the male-to-female ratio decreased after the age of 50-59 year. Of all first AMI patients, 40% died before being admitted to a hospital. The proportion of non-hospitalised AMI patients increased with age in men after the age of 50-59 years. Within the age groups the proportion of out-of-hospital deaths was similar for men and women.
Conclusion: Our study provides the first nationwide incidence estimates of first AMI in the Netherlands. Expected differences in incidence with regard to age and gender were shown. The large proportion of out-of-hospital deaths reinforces the importance of primary prevention AMI.