Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Long-term reduction in sudden deaths after a multifactorial intervention programme in patients with myocardial infarction: 10-year results of a controlled investigation
MLINEN*,
*Rehabilitation Research Centre of the Social Insurance Institution Turku
Second Department of Medicine University of Helsinki Finland
Department of Medicine University of Turku Finland
Received 17 February 1988; revised 13 July 1988; .
Address for Correspondence. Dr Helena H;mlinem, The Rehabilitation Research Centre of the Social Insurance Institution, Peltolantie 3, SF-20720 Turku, Finland.
Abstract
Three-hundred and seventy-five unselected patients below 65 years of age and with acute myocardial infarction participated in a controlled investigation aimed at studying the effects of a multifactorial intervention programme on morbidity, mortality and risk factor control. After ten years' follow-up the significantly lower sudden death and coronary mortality observed three years after myocardial infarction still persisted in the intervention group (188 patients) compared with the control group (187 patients). The incidence of sudden death in the intervention group was 12.8% compared with 23.0% in the controls (P = 0.01). The incidence of coronary mortality was 35.1% and 47.1%, respectively (P = 0.02). No significant difference was found in the number of patients with clinical non-fatal reinfarctions (25.6% and 19.3%, respectively). During the first year, when the mortality difference was most marked, the use of beta blockers was not significantly different between the groups.
The results suggest that with a multifactorial intervention programme which starts early after the infarction and lasts for years a significant long-term reduction in sudden deaths and coronary mortality can be attained.
Key Words: Myocardial infarction • rehabilitation • secondary prevention • risk factors • long-term follow-up
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