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What is the 1-year prognosis regarding mortality and morbidity in an unselected cohort of patients admitted with acute myocardial infarction?
What is the 1-year prognosis regarding mortality and morbidity in an unselected cohort of patients admitted with acute myocardial infarction?
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In an unselected, consecutive series of patients with acute myocardial infarction, 1-year mortality and morbidity are high, with only a small minority remaining free of recurrent events or angina.
Previous descriptions of the prognosis after acute myocardial infarction (AMI) have mainly included patients admitted to coronary care units, often with an upper age limit. This study describes the prognosis, with emphasis on morbidity, during 1 year in 921 patients admitted to one single hospital with AMI regardless of age and regardless of whether or not they were admitted to the coronary care unit. During the first year, 29% of the patients died and 16% developed a reinfarction. Fifty-four percent required rehospitalization for various reasons, mainly for AMI, chest pain of other origins, and congestive heart failure. After 1 year, 52% of the surviving patients had symptoms of angina pectoris. Among patients younger than 65 years, only 37% were back to work full time after 1 year. Of patients alive after 1 year, 25% fulfilled the following criteria: no reinfarction, no rehospitalization, and no angina pectoris. Of patients aged less than 65 years at follow-up, 12% fulfilled the same criteria and were back to work full time after 1 year. In this unselected, consecutive series of patients with AMI, mortality and morbidity were high during the first year. Only a small percentage of patients were free of events or symptoms of angina pectoris.
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Herlitz et al. (1994) studied this question.
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