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European Heart Journal 1986 7(4):305-311;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Predictors of early death after acute myocardial infarction: two months follow-up

H. CLEEMPOEL, H. VAINSEL, R. BERNARD, M. DRAMAIX, A. LENAERS, M. VAN KUYK, M. EWALENKO, M. HOYLAERTS, M. DE MARNEFFE, J. L. VANDENBOSSCHE, M. RENARD, R. HAARDT, R. MESSIN, M. ENGLERT and H. DENOLIN

Department of Cardiology and Laboratory of Cardiology, University Hospital Saint-Pierre Brussels, Belgium

Received 14 June 1985; revised 13 November 1985; .

Address for correspondence: Dr H. Cleempoel Department of Cardiology, University Hospital Saint-Pierre, RuV Hame, 322, 1000 Brussels, Belgium

Abstract

Clinical variables and the results of non-invasive tests (exercise test, echocardiogram, gated equilibrium radionuclide ventriculography and 24 h ECG) were recorded in a series of 202 patients who left the hospital alive after an acute myocardial infarction.

The short term (two months) predictive value of all these data was prospectively assessed by uni- and multi-variate analysis. The best correlation with early death was observed with the variables related to the extent of infarction and left ventricular dysfunction, namely: early clinical signs of heart failure, high peak CK-MB level, complete bundle branch block, increased cardiothroacic ratio on chest X-Ray,number of Mets reached during the stress test, echocardiographic dyskinesia index, and decreased left ventricular ejection fraction as measured by radionuclide ventriculography.

Using multi-variate stepwise discriminant analysis, the following independent prognostic factors appeared by order of entry: early clinical signs of heart failure, peak CK-MB level and cardiothoracic ratio on chest X-Ray.

These results highlight the short-term predictive value of the data related to left ventricular dysfunction and especially of simple clinical data for patients surviving an acute myocardial infarction.

Key Words: Acute myocardial infarction • prognostic indices • non-invasive techniques


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