Long Term Prognosis Following Treatment in a Coronary-Care Unit

Summary: A three-year follow-up of 244 patients admitted to a coronary-care unit is described. The cases were the hospital survivors of 300 patients who had originally been assessed by a coronary prognostic index (CPI) for short-term survival. They were followed firstly, in order to check the findings from an earlier group of patients on whom a second CPI for three years survival had been formulated. Secondly, it had previously been established that acute prognosis was improved by treatment in the coronary-care unit for a group of these patients, and it was therefore important to check their long-term survival. Thirdly, the data provided an opportunity for assessing the effect of arrhythmias during acute myocardial infarction on subsequent survival. The previous findings were confirmed that age, radiological evidence of cardiomegaly and left ventricular failure, and previous myocardial infarction, are all relevant to three year survival. Late mortality was also higher in hypertensive patients, and in those who had suffered anterior transmural infarction. Mortality was well predicted by the CPI for three year survival, and there was no significant difference in mortality from the earlier study. There was no evidence that any arrhythmia during the acute stage of the illness influenced late mortality independently of the other factors.