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changes in case fatality in those aged 75 years and older. While the mortality burden of myocardial infarction has continued to fall across these four populations, the relative contribution of trends in myocardial infarction event rates and case fatality to declining mortality varied between jurisdictions, including by age and sex. Understanding the causes of this variation will enable optimisation of prevention and treatment efforts. National Health and Medical Research Council, Australia; Australian Research Council; Health Research Co