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.