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Learning from regional heterogeneity in outcomes of patients with acute myocardial infarction.

This editorial refers to ‘International comparison of treatment and long-term outcomes for acute myocardial infarction in the elderly: Minneapolis/St. Paul, MN, USA and Goteborg, Sweden’, by L.G. Smith et al. , doi:10.1093/eurheartj/eht196 

Myocardial infarction continues to be one of the most common causes of death and disability world wide—especially in industrialized countries.1 Although the chance of survival after myocardial infarction has improved substantially over the past decades,2–4 the world faces grave challenges for containing a global increase in ischaemic heart disease as low and middle income countries are experiencing a rapid increase in risk factors. Therefore, never has it been more important than now to learn from each other around the globe in order to reduce the burden of ischaemic heart disease. Global benchmarking of processes of care and outcomes in myocardial infarction is such an opportunity that could lead to important insights to improve care. This is even more important in the older demographic of the populations since these patients are at especially high risk.

Gothenburg in Sweden and Minneapolis/St Paul in Minnesota, USA represent cities of two very different, yet similar industrialized nations. Both have been at the forefront of the substantial improvements seen in the treatment of myocardial infarction, including with a focus on improving quality of care. We assume that ischaemic heart disease and the effects of treatments are similar in countries and cities such as these; however, this …