Effect of medical treatment of acute myocardial infarction in coronary care unit. Study on its effect mainly on the cases with complication.

Four hundred sixty-five patients with acute myocardial infarction who were treated in our coronary care unit in the past 14 years were classified into three stages (Stage I, II and III) for the purpose to study the effect of the treatment at CCU in each stage. The mortality in acute phase were 25.8%, 16.1% and 18.8% in Stages I, II and III, respectively. The mortality of cases admitted within 24 hours was 32.2% in Stage I, 27.1% in Stage II and 15.6% in Stage III, decreasing significantly (p less than 0.01) in Stage III. In cases of early hospitalization within 3 hours after the attack, the mortality in Stages I, II and III were 36.6%, 17.2% and 11.4%, decreasing in Stages II and III, specifically significant in Stage III compared with Stage I (p less than 0.01). The mortality in Class III of Killip's classification in each stage was 100% in Stage I, 33.3% in Stage II, and 16.7% in Stage III, and decreased significantly in Stages II and III (p less than 0.01). The mortality in Class IV are still high, although a decreasing tendency is observed as shown in figures such as 87.5% in Stage I, 62.5% in Stage II and 60% in Stage III. Thus, the mortality was markedly improved in cases which were hospitalized in early phase. Therefore, this result implies the importance of measures to promote early hospitalization including educational activity to appeal it. Early hospitalization in CCU is expected to minimize the death of acute myocardial infarction.