In-hospital mortality following acute myocardial infarction and stroke

Ischaemic heart diseases and stroke were the two major causes of death in Asia-Pacific in 2016, accounting for 34.7% and 25.2% of total deaths (WHO, 2018a). Additionally, both are associated with significant health, social and non-financial costs, because of the persistent disabilities suffered by many survivors. Treatment following acute myocardial infarction (AMI) and stroke has advanced greatly over the past decade. Until the 1990s, treatment focused on prevention of complications and rehabilitation. But following the great improvements in AMI survival rates that were achieved with thrombolysis (Gil et al., 1999), clinical trials also demonstrated the benefits of thrombolytic treatment provided within six hours after acute ischemic stroke (O’Rourke et al., 2010; Wardlaw et al., 2014). Dedicated cardiac care and stroke units offering timely and proactive therapy achieve better survival than conservative care (Seenan et al., 2007), although studies have shown that a considerable number of patients fail to receive high-quality, evidence-based care (Eagle et al., 2005).