Acute myocardial infarction mortality in Cuba, 1999-2008

introduction: 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. objective describe acute myocardial infarction mortality in cuba from 1999 through 2008. methods 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. results 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). conclusions 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-h