“…To our knowledge, no previous study has analysed small-area variation in myocardial infarction deaths and its constituents (non-fatal events and pre-hospital and post-admission deaths). Some studies have reported national data for specific countries; most of these studies relied on data from hospitalised patients (ie, excluding pre-hospital deaths), 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 and only some included pre-hospital deaths. 1 , 2 , 28 , 29 , 30 , 31 Our estimated hospital case fatality of around 11% is consistent with the national audit data report in England, 32 and within the 4–17% range in member countries of the Organisation for Economic Co-operation and Development.…”