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The aim was to analyze ischemic heart disease (IHD) and acute myocardial infarction (AMI) mortality. Data on the respective mortality and in-hospital morbidity for the City of Zagreb and Republic of Croatia were retrospectively analyzed. The analysis included data on the number of deaths due to IHD (International Classification of Diseases-10th Revision (ICD-10) code I20-I25) and deaths due to AMI (ICD-10 code I21). Study results revealed the number of deaths from AMI to have continuously decreased from January 1, 2001 until December 31, 2016. During the study period, the age-standardized death rates from AMI decreased by 55.6% and 35.6% in Zagreb and Croatia, respectively. As the number of deaths due to the IHD group of syndromes did not show substantial decline, it was concluded that deaths due to IHD entities other than AMI were on an increase in both Zagreb and Croatia as a whole, calling for more attention to be paid to them. [ABSTRACT FROM AUTHOR]

Background and Aim: The relevance of statin therapy in acute coronary syndrome (ACS) is well-established, but little is known about the optimal timing of statin administration, particularly within the first 24 hours following ACS.1,2 The aim of the study was to gather data on early and late outcomes of ACS patients (pts) through the Croatian branch of the ISACS-CT (International Registry of Acute Coronary Syndromes in Transitional Countries) registry. Patients and Methods: T he d ata w as g athered r etrospectively from January 2012 to October 2017. The study population included 1898 ACS pts: 46.4% (n=881) with STsegment elevation myocardial infarction (STEMI), 36.1% (n=685) with non-ST-segment elevation myocardial infarction (NSTEMI) and 17.5% (n=332) with unstable angina pectoris (UA). Follow-up was performed on 33% (n=630) of the cohort, 43.7% (n=275) with STEMI, 34.4% (n=217) NSTEMI and 21.9% (n=138) with UA. Results: In the first 24 hours following ACS, statins were administered in 1734 (93%) pts (for 24 pts the data is missing), while the pts who received them later or not at all were the control group. The two groups did not differ regarding age, gender, body mass index, left ventricular ejection fraction (LVEF) during initial hospitalization, smoking status, history of diabetes, chronic heart failure or arterial hypertension at initial hospitalization nor at 1-year followup (Table 1). The overall in-hospital mortality rate was 4%, similar to that in pts treated with statins within the first 24 hours (3%), while in pts without early statin treatment, in-hospital mortality rate was 18% (p<0.001). The risk of in-hospital death was significantly higher in pts without early statin therapy (odds ratio [OR] 7.32, 95% confidence interval [CI] 4.371-12.27, p<0.001), while the risk of primary outcome at 1-year follow-up was not significantly different between groups in univariate regression analysis. Older age (OR 1.1, 95% CI 1.06-1.20, p< 0.001), higher creatinine level (OR 1.0, 95% CI 1.005-1.012, p<0.001), lower LVEF (OR 0.90, 95%CI 0.86-0.94, p<0.001) and lack of early statin treatment (OR 3.6, 95% CI 1.0-13.10, p=0.05) were positively associated with increased odds for early primary outcome in multivariable regression model (Table 2). Conclusion: Initiation of statin therapy within the first 24 hours following ACS is associated with a significant reduction in in-hospital mortality, although the positive effect of early statin therapy did not reach statistical significance at 1-year follow-up. [ABSTRACT FROM AUTHOR]