Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Changing characteristics and in-hospital outcome in patients admitted with acute myocardial infarction
Observations from 1982 to 1994
The Department of Cardiology, The Cardiovascular Research Institute Maastricht, Academic Hospital Maastricht, University of Limburg The Netherlands
revised 26 July 1996; accepted 30 July 1996.
Correspondence: Jos W. M. G. Widdershoven, Department of Cardiology, Academic Hospital Maastricht, PO. Box 5800, 6202 AZ Maastricht, The Netherlands
Abstract
BACKGROUND: During the past decade, various new treatments have become available for patients with acute myocardial infarction. The effects of these treatment modalities have been studied extensively in selected patient groups. These studies indicate that early diagnosis, risk stratification and prompt initiation of treatment are of crucial importance for optimal benefit. However, it is not known whether prognosis changed in all patients admitted with an acute myocardial infarction. Also, the characteristics of the infarct population may have changed over time because of new medication regimens, invasive interventions and awareness of the importance of risk factors.
METHODS: We studied all patients admitted with acute myocardial infarction in 1982, 1988 and 1994. Information on baseline characteristics, clinical variables and all interventions was collected.
FINDINGS: In those 3 years 223, 227 and 235 patients were admitted because of an acute myocardial infarction. Patients admitted in 1994 were older, more often female and less often had a previous cardiac history. More patients admitted in that year had previous balloon angioplasty and coronary bypass grafting. Smoking habits decreased during the past decade. In-hospital mortality was 38 (17%) in 1982, 23 (10%) in 1988 and 22 (9%) in 1994 (P<0·05). Variables related to high risk for in- hospital death in 1982 were higher age, low systolic blood pressure, atrial fibrillation, absence of accelerated idioventricular rhythm, sustained ventricular tachycardia and signs of left ventricular dysfunction; in 1988 the occurrence of non-sustained ventricular tachycardia, Killip class more than I, the absence of thrombolytic therapy, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting were independently related to in-hospital death. In 1994, high risk variables for in-hospital death were dyspnoea on admission, sustained ventricular tachycardia, female gender, higher creatinine on admission, and a previous cardiac history.
INTERPRETATION: In-hospital mortality for unselected patients admitted with an acute myocardial infarction decreased between 1982 and 1988 and remained the same between 1988 and 1994, in spite of further ageing of the population. In the study period there has been a change in baseline characteristics and high risk variables for in-hospital death after myocardial infarction.
Key Words: Myocardial infarction • hospital • prognosis • morality • morbidity
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R Liew, S Sulfi, K Ranjadayalan, J Cooper, and A D Timmis Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years Heart, August 1, 2006; 92(8): 1030 - 1034. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Bar, J. Vainer, J. Stevenhagen, K. Neven, R. Aalbregt, T. Oude Ophuis, V. van Ommen, H. de Swart, E. de Muinck, W. Dassen, et al. Ten-year experience with early angioplasty in 759 patients with acute myocardial infarction J. Am. Coll. Cardiol., July 1, 2000; 36(1): 51 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Siniorakis, S. Arvanitakis, G. Voyatzopoulos, P. Hatziandreou, G. Plataris, A. Alexandris, and P. Bonoris Hemodynamic Classification in Acute Myocardial Infarction Chest, May 1, 2000; 117(5): 1286 - 1290. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Gottlieb, U Goldbourt, V Boyko, D Harpaz, L Mandelzweig, Z Khoury, S Stern, S Behar, and for the SPRINT and Israeli Thrombolytic Survey Gro Mortality trends in men and women with acute myocardial infarction in coronary care units in Israel. A comparison between 1981-1983 and 1992-1994 Eur. Heart J., February 2, 2000; 21(4): 284 - 295. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Gil, J. Marrugat, J. Sala, R. Masia, R. Elosua, X. Albert, A. Pena, J. Vila, M. Pavesi, and G. Perez Relationship of Therapeutic Improvements and 28-Day Case Fatality in Patients Hospitalized With Acute Myocardial Infarction Between 1978 and 1993 in the REGICOR Study, Gerona, Spain Circulation, April 6, 1999; 99(13): 1767 - 1773. [Abstract] [Full Text] [PDF]
|
|