{"id":"f95a596d93f4","type":"article","url":"https://hartvaat.nl/2026/03/25/waarom-de-sterfte-na-een-hartinfarct-daalde-15-jaar-nationale-data-uit-engeland-/","title":"Waarom de sterfte na een hartinfarct daalde: 15 jaar nationale data uit Engeland en Wales","title_en":"Drivers of 1-year mortality decline after acute myocardial infarction in England and Wales: a 15-year national cohort study","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","myocardinfarct","vrouwen"],"journal":"Heart","doi":"http://heart.bmj.com/cgi/content/short/112/8/446?rss=1","source_url":"https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/446?rss=1","authors":["Ayayo","S. A.","Martin","G. P.","Zghebi","S.","Taxiarchi","V. P.","Rashid","M.","Kontopantelis","E.","Mamas","M. A."],"significance":7,"published":"2026-03-25","source_date":"2026-03-25","image":"https://hartvaat.nl/global/img/2ea89016db5e.webp","kennis":["https://hartvaat.nl/kennis/cardiometabool/metformine-cardiovasculair/","https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"One-year mortality after acute myocardial infarction (AMI) has declined over time, but the reasons were unclear. In this analysis of 852,914 AMI patients in England and Wales (2005-2019), decomposition analysis examined which factors contributed to the trend. One-year mortality fell from 22.8% to 14.2% — an absolute reduction of 8.6 percentage points. About 68% of this decline was explained by measured factors, the greatest contributor being increased use of evidence-based pharmacological therapy. The remainder stayed unexplained. The findings show that broader use of proven medications has been the main driver of improved post-infarction survival — an important pointer for clinical strategy and policy.","created":"2026-07-03T10:32:21Z","updated":"2026-07-03T18:39:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De 1-jaarssterfte na een acuut myocardinfarct (AMI) is in de loop der jaren gedaald, maar de oorzaken waren onduidelijk. In deze analyse van 852.914 AMI-patiënten in Engeland en Wales (2005-2019) werd met decompositie-analyse onderzocht welke factoren bijdroegen aan deze trend. De 1-jaarssterfte daalde van 22,8% naar 14,2% — een absolute afname van 8,6 procentpunt. Ongeveer 68% van deze daling werd verklaard door gemeten factoren, met als grootste bijdrage het toegenomen gebruik van evidence-based medicamenteuze therapie. Het resterende deel bleef onverklaard. De bevindingen tonen dat vooral de bredere inzet van bewezen geneesmiddelen de overleving na een hartinfarct heeft verbeterd — een belangrijk aanknopingspunt voor klinische strategie en beleid.","abstract_original":"Background\n

One-year mortality following acute myocardial infarction (AMI) has declined over time, yet the reasons for this improvement remain unclear. Understanding the drivers of these changes is essential for informing clinical strategies and health policy.

\n\nMethods\n

We analysed 852 914 adult patients admitted with AMI across England and Wales between 2005 and 2019 using national registry data. We examined changes in 1-year all-cause mortality and quantified the contribution of clinical, treatment and demographic factors to this trend using decomposition analysis.

\n\nResults\n

Between 2005 and 2019, 1-year all-cause mortality declined from 22.8% (95% CI 22.4% to 23.2%) to 14.2% (95% CI 13.7% to 14.7%), an absolute reduction of 8.6 percentage points. Approximately 68.2% of this decline was explained by measured factors. The greatest contributor was increased use of evidence-based pharmacological therapies—includin"}