Key result
Heart failure during acute myocardial infarction was the only statistically significant independent risk factor for mortality, with overall patient survival at 86% at 3 years.
Cohort (n=102)
In patients surviving an acute myocardial infarction, the development of heart failure during the acute phase is the strongest independent predictor of late mortality.
In-hospital HF post-MI flags survivors for intensified monitoring; hypothesis-generating for targeted interventions to reduce late mortality.
A group of 102 patients (66 males, age 62 +/- 11 years) surviving an acute myocardial infarction was followed for 6 to 48 months. Survival was analyzed by the method of Kaplan Meier and Cox analysis was used to identify prognostic factors. Thirteen patients died during follow up: 3 had sudden death, 3 a stroke, 3 died from heart failure, 3 had reinfarction and cardiogenic shock and 1 died from cholangitis. Most deaths occurred in the first few months of follow up. Survival was 92% at 6 months, 90% at 1 year, 88% at 2 years and 86% at 3 years after infarction. Single variable analysis disclosed a 2 to 3 fold late mortality risk associated to the presence of age over 60 years, old myocardial infarction, hypertension, diabetes mellitus and ventricular tachycardia or fibrillation during the acute phase. Greater than 3 fold risk was seen for patients developing heart failure or shock during myocardial infarction. Heart failure was the only statistically significant risk factor identified by multivariate analysis.
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Laņas et al. (1994) conducted a cohort in Acute myocardial infarction (n=102). Heart failure during acute myocardial infarction was the only statistically significant independent risk factor for mortality, with overall patient survival at 86% at 3 years.
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