A good report card, but there is room for improving care for patients with myocardial infarction

Improving systems of care can achieve earlier treatment and increase survival

The report by Nadlacki and colleagues1 on long term outcomes for patients after myocardial infarction provides much needed clarity about progress in care in Australia and New Zealand during 2009‒2015. The next step, well overdue, is a prospective, comprehensive registry based on the current universal definition of myocardial infarction,2 rather than on information derived from administrative data using International Classification of Diseases (ICD) codes. The major advances in terms of technology, pharmacology, and patterns of care for people with myocardial infarction in Australia and New Zealand should not lead to complacency; improvements are still required, at both the systems and local levels, to achieve good quality care for all. For this we need outcomes data for unselected patients with myocardial infarction, as has been collected in New Zealand for almost a decade (ANZACS‐QI)3 and in Sweden for more than two decades (the SWEDEHEART registry).4