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European Heart Journal 1985 6(4):294-302;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Recurrent myocardial infarction. 1. Natural History of fatal and non-fatal events

G. ULVENSTAM*,, A. ÅBERG*, R. BERGSTRAND*, S. JOHANSSON*, K. PENNERT*, A. VEDIN*, H. WEDEL{dagger}, L. WILHELMSEN* and C. WILHELMSSON*

*Section of Preventive Cardiology, Department of Medicine, Östra Hospital S-416 85 Göteborg
{dagger}The Nordic School of Public Health Medicinaregatan, S-413 45 Göteborg, Sweden

Received 1 June 1984; revised 20 December 1984; .

Requests for reprints to: Dr Goran Ulvenstam, Department of Medicine, Östra Hospital, S-416 85 Göteborg, Sweden.

Abstract

1306 men below 68 years of age who survived a first myocardial infarction (MI) during 1968–1977 were followed up between 2 and 12 years after discharge from hospital. The mean follow-up time was 6.5 years. The patients were unselected and paid regular visits to a Post-MI Clinic where treatment was standardized.

The diagnosis of a non-fatal reinfarction was based on conventional clinical criteria, and the diagnosis of fatal reinfarction on autopsy findings of a recent myocardial injury and/or a fresh coronary thrombus. The autopsy rate was high and the follow-up of endpoints was complete.

The total cumulative rate of endpoint free patients was 64% at 5 years and 50% at 10 years follow-up. The total mortality rate was 19% at 5 years and 33% at 10 years follow-up. The total cumulative rate of a first reinfarction was 28% at 5 years and 37% at 10 years follow-up (80% non-fatal and 20% fatal). 63 patients suffered more than one reinfarction. The mortality rate was strongly associated with age. In contrast the rate of non-fatal reinfarctions was independent of age.

Key Words: Myocardial infarction • recurrent myocardial infarction • prognosis • mortality


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