Introduction
One of the earliest population-based surveys regarding the incidence and
treatment of myocardial infarction was initiated and co-ordinated by the
World Health Organisation approximately 30 years ago (1). Over the past
two decades, many European and Far Eastern countries have launched
registries covering the entire population (2-5), and several comparative
international studies have been performed (6-9). Due to the varying
methodologies of these registries, the comparative evaluation of data
has only been possible with certain limitations (10). Following these
instances, the European Society of Cardiology initiated the creation of
a system that applies a uniform methodology, currently in its pilot
phase (11). Such an infarction registry has been available in Hungary
since 2014, which is both nationwide and mandated (Hungarian Myocardial
Infarction Registry=HUMIR) i.e., in-depth research on the quality
parameters of infarction care is possible
(12). The mechanisms and funding
of healthcare systems are significantly different across countries.
Several studies report that depending on an individual’s health
insurance, social situation, educational background and several other
factors, extreme inequalities may occur in the healthcare received
between— and even within—certain countries (13-15). According to the
statistical system of the European Union, Hungary can be divided into
three major socio-economic regions—west Hungary, central Hungary and
east Hungary—which exhibit significant sociological and economic
differences. According to the data of the Hungarian Central Statistical
Office, the GDP per capita is 6,073, 3,581 and 2,722 EUR in the central
(CR), western (WR) and eastern (ER) regions, respectively. The
proportions of those exposed to poverty and social exclusion are nearly
identical in the CR and WR in the total population (22.4% vs. 22.5%);
however, this rate is significantly higher in the ER (30.4%). The
regions and their population data are presented in Figure 1 .
The aim of this investigation was to compare the incidence, prehospital
delay, clinical data, hospital treatment and prognoses of acute
myocardial infarction (AMI) in three socio-economically distinct regions
of Hungary by analysing data from the national and mandated myocardial
infarction registry.