Acute myocardial infarction in Singapore - An epidemiological study

Abstract

This thesis reports the trends, ethnic and gender differences in the occurrence and survival of >12,000 patients, between the ages of 20 and 64 years, with acute myocardial infarction in Singapore from 1991 to 1999. The data were derived from the carefully designed Singapore Myocardial Infarction Register using modified procedures of the World Health Organization Multinational Monitoring of Trends and Determinants of Cardiovascular Disease Project. Acute myocardial infarction event rates in Singapore declined from 98 to 83 per 100,000 residents. Compared with Chinese, the rate ratio was 3 for Indians and 2 for Malays. Correspondingly, the 28-day case-fatality rates fell from 28% to 22%, with the lowest rate for Indians, highest for Malays and intermediate for Chinese. Malays had the highest long-term case-fatality. Mortality was greater for women than men. However, the gender gap varied substantially with age and among different ethnic groups. Young Malay patients had the widest disparity.