the development of a national action plan on amr was initiated by the ministry of health in falling smoking prevalence and the introduction of local cardiac services from the mid s explain part of the steady decline in heart disease yet malta records relatively high levels of deaths within days of admission to hospital for acute myocardial infarction at per admissions among those aged years and older compared with in the eu and in italy similarly higherthaneuaverage casefatality rates were recorded for people hospitalised for stroke taken together this may point to potentially systemic challenges in providing high quality treatment in the acute sector although further investigation of the data is needed to better understand the causes for malta s lower performance on these indicators