Regional variation in incidence and case fatality of myocardial infarction among young women in England, Scotland and Wales
1N R Dunn, 1A Arscott, 2M Thorogood, 3B Faragher, 4L de Caestecker, 5T M MacDonald, 6C McCollum, 7S Thomas, 1R D Mann
1Drug Safety Research Unit, Bursledon Hall, Blundell Lane Southampton, SO31 1AA, UK
2London School of Hygiene and Tropical Medicine, London
3Department of Organisational Health Psychology, Manchester School of Management, UMIST, Manchester
4Department of Public Health, Greater Glasgow Health Board, Glasgow
5Medicines Monitoring Unit, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital Medical School, Dundee
6Department of Surgery, South Manchester University Hospital, West Didsbury, Manchester
7Wolfson Unit of Clinical Pharmacology, University of Newcastle, Newcastle upon Tyne
Abstract
Objectives - To examine the regional variation in incidence and case fatality of myocardial infarction among young women.
Design - Cross sectional survey, using population based incidence data.
Setting - England, Scotland and Wales.
Subjects - Subjects were women aged 16-44 with a diagnosis of myocardial infarction between 1 October 1993 and 15 October 1995.
Outcome measures - Incidence of myocardial infarction per 100,000 women years, with case fatality as a percentage of total cases.
Results - Incidence of myocardial infarction rose steeply from age 33 upwards, (maximum = 20.2 cases per 100,000 women years at age 44). The adjusted incidence rate for myocardial infarction was 3.7 (95% CI 3.2, 4.2) times greater in Scotland than in southern England. In contrast, case fatality was significantly lower in Scotland: 18.5% (95% CI 13.1%, 25.0%), compared with 31.0% (95% CI 25.9%, 36.0%) in southern England.
Conclusions - The incidence of myocardial infarction varied widely within the United Kingdom. Case fatality variation may reflect differences in ambulance response, or in diagnostic acumen, within the regions.
KEY WORDS - myocardial infarction, MI, young women
