Mobile coronary care and community mortality from myocardial infarction.

Over a 15-month period all episodes of suspected myocardial infarction were documented in two similar communities in Northern Ireland. The hospital coronary-care facilities were similar but only one area had a mobile coronary-care service. The incidence of myocardial infarction was similar in the two areas but the community mortality at 28 days was lower in all age-groups in the area served by the mobile unit. The difference in mortality was more pronounced in younger age-groups. Among those aged less than 65 the mortality rates in the two areas were 55% and 34%. The treatment in the two areas differed only in that it was provided about 2 h earlier where mobile care was available. The results suggest that the impact of early pre-hospital coronary-care on community mortality has been seriously underestimated.