[Epidemiology according to the European and French scales of myocardial infarction. Data of the MONICA project].

Ischaemic heart disease is a perfect example of variability. The official mortality statistics in Europe show a gradient from 1 to 5. France is a zone at low risk even if deaths of undetermined causes are taken into account. This gradient is confirmed by the data from the Registries of the MONICA project. In France, the official mortality figures show a decrease of 28% in coronary mortality between 1985 and 1991 in men, throughout France. The differences in incidence of myocardial infarction between Lille and Toulouse in the MONICA project are not important but the differences in mortality are worrying. Between 1985 and 1991, the three registries show a 7% decrease in mortality (p < 0.001) and a 25% decrease in recurrences (p < 0.001) with an increase in primary infarcts of 8.3% (p < 0.05). There has been an increase in the prescription of betablockers, thrombolytics, ACE inhibitors and aspirin during the acute phase and at discharge form hospital. French cardiologists have followed the recommendations of the large scale clinical trials published during this period. The improved hospital mortality corresponds to the beneficial results reported in trials with aspirin, betablockers, ACE inhibitors and thrombolytics.