Coronary artery disease is increasing in developing countries as western lifestyles are adopted. Between 1990 and 2001, 250 patients were admitted to rule out myocardial infarction in Antigua, 55% were confirmed. Based on available population figures, the incidence of hospitalization was 0.73 per year per 1000 men and 0.24 per year per 1000 women age 35 to 74 years in Antigua. This rate is less than 20% of the rate for the United States of America.