Cantonal Hospital Zenica1, University Clinical
Center Tuzla2, General Hospital Orašje3, Bosnia and Herzegovina
AND GENDER RELATED INCIDENCE AND MORTALITY OF PATIENTS WITH
ACUTE MYOCARDIAL INFARCTION IN CANTONAL HOSPITAL ZENICA FROM
1991 TO 2000
Abdović1, F. Baraković2, D. Mott3 and S. Avdagić2
incidence and mortality of patients with acute myocardial infarction
(AMI) has been followed up («hot pursuit») in ten-years period,
during the war in Bosnia (from 1992 to 1995), including also a
year before and five after. The influence of war-induced stress
and some circumstances (depressive status, starvation, physical
activity) on the incidence and mortality of acute coronary artery
disease was perceived. Cardiac enzymes and electrocardiograms
werw controlled to all patients with AMI. Echocardiography has
been investigated if it was necessary for diagnosis and prognosis.
A total of 1949 patients with AMI were hospitalized. There were
66% of male patients. Increase of incidence of AMI in the first
war year continues with gradually decrese until the last year
of war with revise of increase in postwar years. A total of 365
patients died and mortality was 19%. In the prewar year mortality
was only 10%. Maximal mortality was noticed in the first war year
(22%) and in second postwar year (25%). Majority of patients i.e.
55% were within 56 to 70 years of age. Patients aged 40 years
of less represented only 4% of total population with mortality
of 2,6%. Maximal mortality (26%) was in population aged 65 years
and more (38% of total population). Female mortality (23%) was
higher than male's (16%). In annual review male mortality was
balanced, always below 20%, after initial increase in 1st war
year. Opposite, female mortality course was irregular with two
peaks in 1st war (31%) and 2nd postwar (41%) year and decrease
(8%), was noticed during the war (below man's mortality value).
Increase of incidence and mortality in the first year of war can
be explained by war-induced acute stress and by migration of displaced
people. Rise of female mortality occurred as results of mental
stress, which was induced by war conditions and aggravating family
circumstances in postwar period (bad socio-economic status: high
degrees of unemployment and absence of psychic and social prosperity).
Decrease of female mortality can be explained by facultative engagement
in war activities.