Circulation, Vol 62, 960-970, Copyright © 1980 by American Heart Association
GJ Taylor, JO Humphries, ED Mellits, B Pitt, RA Schulze, LS Griffith and SC Achuff
Patients who survive an acute myocardiac infarction (AMI) have significant
coronary disease and are at risk for angina pectoris, recurrent myocardiac
infarction and sudden death. This study provides data gathered
prospectively for 106 patients surviving myocardial infarction who had
coronary arteriography, left ventriculography and 24- hour
electrocadiographic recordings before hospital discharge and were followed
30 months. Univariate analysis showed that low ejection fraction, proximal
left anterior descending coronary disease and significant disease in all
three coronary arteries were associated with a high risk of sudden cardial
death. The ECG location or type of infarction was not helpful in predicting
mortality, reinfarction or continuing angina. Multivariate analysis of 30
clinical and laboratory variables identified previous myocardial infarction
and an ejection fraction less than 40% as the best predictors of mortality;
all 13 patients who died were identified by these two variables.
Three-vessel coronary artery disease, proximal left coronary disease and
complicated late hospital-phase ventricular arrhythmias did not provide
additional information about mortality once the information provided by the
first two variables was considered. Multivariate analysis identified
hypertension, three-vessel coronary disease, postinfarction angina pectoris
and previous AMI as significant predictors of recurrent AMI during the 30
month follow-up.
ARTICLES
Predictors of clinical course, coronary anatomy and left ventricular function after recovery from acute myocardial infarction
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