Patients with acute chest pain in whom myocardial infarction was ruled out had a similar rate of MI or death at 27.8 months compared to those with documented MI (21.6% vs 21.8%).
Cohort (n=211)
No
Do patients hospitalized with acute chest pain in whom myocardial infarction has been ruled out have a better prognosis than those surviving a documented infarction?
Patients hospitalized with acute ischemic chest pain without an evolving myocardial infarction have a similar long-term prognosis for death or subsequent infarction as those surviving an acute myocardial infarction.
Absolute Event Rate: 21.6% vs 21.8%
To determine the prognosis after hospitalization of patients hospitalized with acute chest pain in a coronary-care unit, we undertook a prospective study of 211 consecutive admissions to the Stanford Coronary Care Unit. On the basis of predetermined criteria, 16 patients were found to have noncardiac chest pain, and myocardial infarction was ruled out in 89, one of whom died in the hospital. Infarction was documented in 84 others, six of whom died in the hospital. Prospective follow-up after hospitalization was carried out in the 88 patients in whom infarction was ruled out and in the 78 patients who survived infarction. The rate of myocardial infarction or death was 8.0 per cent at six months and 21.6 per cent at a mean of 27.8 months of follow-up for patients who had infarction ruled out, as compared with 7.7 per cent at six months and 21.8 per cent at a mean of 27.8 months of follow-up for those who had a documented infarction during the initial hospitalization. Cardiomegaly, congestive heart failure, and angina after discharge from the hospital tended to increase the risk of morbidity and mortality in both groups. The patient hospitalized with acute ischemic chest pain without evolution of a myocardial infarction has a six to 24-month prognosis similar to that of the patient hospitalized with an acute infarction, and therefore requires similar diagnostic and therapeutic assessment.
Schroeder et al. (Thu,) conducted a cohort in Acute chest pain (n=211). Myocardial infarction ruled out vs. Documented myocardial infarction was evaluated on Myocardial infarction or death. Patients with acute chest pain in whom myocardial infarction was ruled out had a similar rate of MI or death at 27.8 months compared to those with documented MI (21.6% vs 21.8%).