Letters Hospital variation in AMI outcome in UK and Sweden

Variation in outcome of acute myocardial infarction in Sweden and the UK may be due to population heterogeneity in the UK

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5133 (Published 30 September 2015) Cite this as: BMJ 2015;351:h5133
  1. Rajeev Gupta, consultant cardiologist1
  1. 1Kalba Hospital, Kalba, Sharjah, United Arab Emirates
  1. rajeevsavita.gupta{at}gmail.com

One factor that might explain the disparity between Sweden and the UK in the outcome of acute myocardial infarction (AMI) is that the UK population is more heterogeneous than the Swedish one, with a large proportion of the UK population coming from Asia and Africa.1

Because Asian and African people develop AMI about a decade earlier than white people,2 they have less associated morbidity and mortality. Mortality in patients with AMI will therefore be lower in UK hospitals in areas with a high proportion of Asian and African people than in hospitals serving mainly white people because of the age difference of the patients—a major predictor of early mortality in AMI.

Because most people in Sweden are white, those with AMI are elderly and have similar morbidity and mortality patterns. Therefore the fact that there is less variation in the outcome of AMI in Sweden than in the UK is not surprising.


Cite this as: BMJ 2015;351:h5133


  • Competing interests: None declared.


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