Single and Multiple Attacks of Transmural Myocardial Infarction

We dealt with the age and prognosis of 484 persons experiencing a first attack of true transmural myocardial infarction who survived long enough to be hospitalized and have an electrocardiogram. One hundred and one patients experienced two attacks, and 15 patients had three attacks. The third attack proved fatal in every instance and death was fairly sudden. The attrition rate for the initial attack was 21.3% for the first three months, 6.6% for the next nine, 5% for the second year, but only 2% per year between the second and 12th year. For the 101 patients who had a second attack, 39% died within three months, 47.7% after one year, and 73.5% within five years. There is not, and cannot be, an accurate death rate for first attacks in which the patient is hospitalized, since it does not include the more than 40% dead before any possible medical treatment. However, the prognosis after recovery from the first attack was accurate since all patients were observed.