Copyright © 1998 by the European Society of Cardiology.
Improved long term prognosis after myocardial infarction 1984–1991
Department of Medicine, Östra University Hospital, Göteborg, Sweden
accepted February 25, 1998
Aims We set out to examine whether long term prognosis in terms of 2-year mortality after myocardial infarction has improved after the introduction of intravenous beta-blockers, nitroglycerin infusion, aspirin and thrombolytics, in an unselected population of patients hospitalized with a myocardial infarction.
Methods and Results We investigated retrospectively 3791 acute myocardial infarctions in 3187 Göteborg women and men (1039 women and 2148 men), who were consecutively admitted to the coronary care unit at the Östra hospital during 1984–1991. Throughout this period, data were entered continuously into the coronary care unit database. Mortality data were collected through the Swedish cause-specific mortality register. The primary end-point was mortality within 2 years after the onset of the index infarction. Two-year mortality decreased from 36% in 1984 to 25% in 1991. In a Cox regression model (including myocardial infarctions up to 1993) year of hospitalization, age, diabetes mellitus, sex, prior myocardial infarction and indeterminable infarct location all had a significant impact on survival after myocardial infarct. Thrombolytic therapy and hypertension had no prognostic significance.
Conclusion Against a background of radical changes in the treatment of acute myocardial infarction during 1984– 1991 we have seen decreasing in-hospital mortality as well as a substantial decrease in 2-year mortality.
Key Words: Myocardial infarction, prognosis, thrombolytic therapy
f1 Correspondence: P. Abrahamsson, Department of Medicine, Sahlgrenska Universitetssjukhuset/Östra, 416 86 Göteborg, Sweden.
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