Five-year survival of 728 patients after myocardial infarction. A community study.

Abstract

The mortality also was higher for recurrent acute myocardial infarctions than for first attacks. The fiveyear mortality for women was less (20.5%, age-adjusted) than for men (31-6%). This is mainly because of the higher incidence of nontransmural infarcts in women. Acute ischaemic heart disease is more common, more often fatal, and has a poorer long-term prognosis in men than in women in Helsinki. The acute mortality from acute ischaemic heart disease is high in Helsinki when compared with other WHO registers and, in addition, the long-term prognosis seems to be relatively poor in Helsinki. Received for publication 14 May 1979 The high acute myocardial infarction attack rate among Finns and their high early mortality have been shown in several studies,1-5 but it is not known if the long-term prognosis after myocardial infarction is worse than elsewhere.In the present study the five-year survival after the acute phase of acute myocardial infarction of the 728 patients from the Helsinki Coronary Register was studied in relation to age, sex, previous infarction, and transmural infarction. Patients and methodsThe Coronary Register in Helsinki records all cases suspected of having an attack of acute ischaemic heart disease among residents of Helsinki under 66 years of age. The completeness of recording is checked in many ways. A detailed description of the operation of the WHO Registers and in particular of the Helsinki Register5 has been published previously.6-8 Collection of data was almost complete for deceased cases as the death certificates of all Helsinki residents are sent to the municipality 176

Preinfarction Blood Pressure and Smoking Are Determinants for a Fatal Outcome of Myocardial Infarction

“…9,26 However, several studies 9,15,16,[18][19][20][21]25 of predictors for case fatality and survival rates in MI were hospital based. Some studies included only subjects who initially survived a heart attack, 11,14,19,21 measured risk factors after the first event, 9,11,19 or included first and recurrent attacks, 3,18,20 although a study among survivors may not reveal the most important causes of a fatal outcome in MI. Community-based studies of risk factors for case fatality and survival rates after heart attacks are few.…”

“…1,[8][9][10][11][12] Factors that are known to influence the case fatality rate are an advanced age, 1,3,[12][13][14][15] a previous infarct, 1,10,12,14 and diabetes mellitus. 10,[16][17][18] Some studies claim that women fare better 11,14,17,18 or worse 19,20 than men after a major heart attack, while others [21][22][23][24][25] found no independent effect of sex. The size and location of an infarct are important immediate predictors for subsequent death.…”

In-Hospital Death from Ischaemic Heart Disease

“…Failure of the myocar dium to compensate for the infarcted muscle mass may contribute to haemodynamic im balance in AMI patients [17], Obstructive coronary artery disease seems to be more severe in patients who have an old myocar dial infarct lesion than in those who have none [25]. The prognostic significance of re current infarctions has, in fact, been shown in follow-up studies of AMI patients [15,20,21]. The progress of coronary care is thus controversial since improvement in the sur vival of an acute attack increases the pool of patients most susceptible to death in associa tion with the next attack.…”

Long-Term Prognosis after a First Myocardial Infarction in Turkey: Determinants of Mortality and Reinfarction

“…Mortality rates were reported to be 12% in the 1st year, 33% in the 5th year and 48% in the 9th year [11], 11% in the 1st year, 30.1% in the 5th year [12], 9% in the 1st year, 14% in the 3rd year [3], The lst-year mortality in our population was similar to that of Davis et al [3], but was relatively lower than those of most of the other studies [5,11,12], Cumula tive mortality rates within 3, 5 and 10 years were also found to be lower than previously reported rates [11,12], Differences in the studied populations might influence direct comparison of mortali ty rates. There were age restrictions in most of the reported studies [3,[11][12][13][14], It is known that advanced age is associated with higher mortality. Although patients older than 70 years were not excluded from this study, mor tality rates were found to be lower than in some of the above-mentioned studies.…”