Population-specific information on the natural history of AMI, including mortality rates and health service use, is important for service planning and evaluation and for individual patient care. This study evaluated one-year clinical outcomes and health service use of a national sample of patients admitted to Irish hospitals for AMI. METHOD All Irish hospitals admitting >25 patients annually for AMI (n=38) recorded details on 25 consecutive admissions for suspected AMI. Of 950 patients, 795 (70%) were confirmed as having an AMI. At one year post-AMI, hospital records and GP data was obtained regarding clinical outcome and hospital and GP service use. RESULTS Of 425 medical charts sought, 91% were available for consultation. The GP survey had a 56% response rate. 79 (8%) of patients died in hospital and a further 1% within 30 days of admission. A further 1% died over the subsequent year (overall one-year mortality: 10%). 58% of patients received thrombolysis. Length of hospital stay was 12.7 days (mean)(SD 9.8) with an average 8.0 (62) GP visits over the subsequent year. 7.5% of patients underwent revascularisation (3.5% CABG; 4% PTCA) while 3% of patients had a repeat AMI in this year. At the end of the year, 78% were being prescribed aspirin, 12% anticoagulants, 34% ace inhibitors and 31% beta blockers. GPs reported that 8% of patients had undertaken a formal cardiac rehabilitation programme but for a further 21% of patients, GPs reported not knowing whether patients had done a programme. These data provide a first national profile on the aftermath of AMI in Ireland and identify areas for further improvement in service delivery.