A Study on The Trend of The Incidence and Fatality Rates and Factors Related to Development of Ischemic Heart Disease and Sudden Death

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To elucidate the incidence and mortality rates of acute myocardial infarction (AMI) and sudden death in Niigata and Nagaoka cities, we constructed a registration system. Whenever a case, aged 15 to 65 years, occurred from April, 1994 to March, 1995, the attending physician notified it to the registry office and a doctor in charge reviewed medical charts. Only the cases confirmed as definite AMI according to MONICA criteria or as sudden death defined as death within 24 houes were registered. To check the registration rate, all death certificates were inspected separately. An interview with the patient himself or deceased family was done by a trained nurse to obtain information on all cases. The same interview was done with the 544 control subjects who received health check-up in an institute. 70 cases of AMI (survivor cases : 67, cases which died later than 24 hours from the occurrence : 3) and 83 sudden death cases were registeres. Chart review revealed that 7.5% of the registered sudden death cases died from AMI.In the death certificate inspection, there were 3 AMI cases and 154 sudden death cases. Based on the total number of AMI cases estimated from these case numbers, the annual incidence rate for AMI was 17.1/100,000 population (39.5/100,000 for the age group 45-65 years). Diseases of circulatory system were more frequently seen in sudden death cases and coronary risk factors, in AMI cases. Symptomes related to autonomic nervous system such as sbnormal perspiratio and hot and cold feelings appeared more frequently in both case groups during one week before disease occurrence. Sudden death group had a greater daily labor load and a higher rate of those who had decrease in sleeping hours during that week than the AMI group. Cases who complained of stress were frequent only in the AMI cases.