Summary
Aim : To examine the incidence and treatment of acute myocardial
infarction (AMI) as well as 30-day and 1-year prognoses of patients in
three major regions of Hungary by analysing data from the country’s
continuous and mandated infarction registry. Methods and
results : The total population of Hungary is currently 9.8 million: 39%
live in the eastern region (ER), 31% in the Central region (CR) and
30% in the western region (WR). These regions exhibited significant
differences in income and people exposed to poverty. Population over 30
years, the age-standardised incidence of AMI was 177.5 (175.7–179.3)
per 100,000 person-year. During hospital treatment, 82.5%–84.6% of
patients with ST-elevation (STEMI) and 54.8%–81.8% without
ST-elevation (NSTEMI) underwent PCI. The total ischaemic time was
shortest in WR:221 minutes. In the STEMI group, the 30-day mortality
rates of males were lowest in the WR (p = 0.03). If PCI was performed,
mortality rates for both sexes were lowest in the WR (p <
0.01; p = 0.04). The 1-year mortality rate in the male population who
received PCI was lowest in the WR. In the NSTEMI group, the 30-day
mortality rate exhibited no differences. Regarding 1-year mortality,
those who underwent PCI in the WR showed the lowest mortality.Conclusion : The major regions of Hungary exhibited significant
differences regarding the prehospital delay, the incidence, treatment
and mortality of AMI. Logistic regression analysis confirmed the
independent prognostic significance of the region on the 30-day
mortality of patients with STEMI (Hazard ratio = 0.88, p = 0.0114).