Two Decades of Progress in Cardiovascular Health: Declining Mortality and Years of Life Lost from Acute Myocardial Infarction in Poland

Abstract

Background: The aim of the study was to assess trends in mortality and years of life lost due to acute myocardial infarction (AMI) in Poland between 2000 and 2023. Methods: We analysed aggregated, fully anonymised registry data comprising 431,793 death certificates of Polish residents who died from acute myocardial infarction (AMI). Standardised death rates (SDR) were calculated. Premature mortality was assessed using the Standard Expected Years of Life Lost (SEYLL). Trends were evaluated with joinpoint regression, estimating annual percentage change (APC) and average annual percentage change (AAPC). Results: During the study period, AMI deaths declined from 28,737 in 2000 to 11,328 in 2023, a 2.5-fold reduction. SDR decreased from 115.9 to 31.2 per 100,000, with an overall AAPC of −5.6% (p < 0.05). Declines were greater in men (AAPC −5.7%) than in women (−5.3%). SEYLL decreased from 608,488 years in 2000 to 191,476 years in 2023, representing a >70% reduction, with similar relative declines in men and women. SEYLLd fell from 21.2 to 16.9 years, indicating improved survival and older age at death. A temporary stagnation was observed between 2017 and 2020, followed by renewed steep declines thereafter. Conclusions: AMI mortality and YLL in Poland decreased markedly in the study period, reflecting advances in secondary prevention and public health.