OBJECTIVE: To examine the management and outcome of an unselected consecutive series of patients admitted with acute myocardial infarction to a tertiary referral centre. DESIGN: A historical cohort study over a three year period (1992-94) of consecutive unselected admissions with acute myocardial infarction identified using the HIPE (hospital inpatient enquiry) database and validated according to MONICA criteria for definite or probable acute myocardial infarction. SETTING: University teaching hospital and cardiac tertiary referral centre. RESULTS: 1059 patients were included. Mean age was 67 years; 60% were male and 40% female. Rates of coronary care unit (CCU) admission, thrombolysis, and predischarge angiography were 70%, 28%, and 32%, respectively. Overall in-hospital mortality was 18%. Independent predictors of hospital mortality by multivariate analysis were age, left ventricular failure, ventricular arrhythmias, cardiogenic shock, management outside CCU, and reinfarction. Hospital mortality in a small cohort from a non-tertiary referral centre was 14%, a difference largely explained by the lower mean age of these patients (64 years). Five year survival in the cohort was 50%. Only age and left ventricular failure were independent predictors of mortality at follow up. CONCLUSIONS: In unselected consecutive patients the hospital mortality of acute myocardial infarction remains high (18%). Age and the occurrence of left ventricular failure are major determinants of short and long term mortality after acute myocardial infarction.
OBJECTIVE: To examine the management and outcome of an unselected consecutive series of patients admitted with acute myocardial infarction to a tertiary referral centre. DESIGN: A historical cohort study over a three year period (1992-94) of consecutive unselected admissions with acute myocardial infarction identified using the HIPE (hospital inpatient enquiry) database and validated according to MONICA criteria for definite or probable acute myocardial infarction. SETTING: University teaching hospital and cardiac tertiary referral centre. RESULTS: 1059 patients were included. Mean age was 67 years; 60% were male and 40% female. Rates of coronary care unit (CCU) admission, thrombolysis, and predischarge angiography were 70%, 28%, and 32%, respectively. Overall in-hospital mortality was 18%. Independent predictors of hospital mortality by multivariate analysis were age, left ventricular failure, ventricular arrhythmias, cardiogenic shock, management outside CCU, and reinfarction. Hospital mortality in a small cohort from a non-tertiary referral centre was 14%, a difference largely explained by the lower mean age of these patients (64 years). Five year survival in the cohort was 50%. Only age and left ventricular failure were independent predictors of mortality at follow up. CONCLUSIONS: In unselected consecutive patients the hospital mortality of acute myocardial infarction remains high (18%). Age and the occurrence of left ventricular failure are major determinants of short and long term mortality after acute myocardial infarction.
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Authors: C L Grines; K F Browne; J Marco; D Rothbaum; G W Stone; J O'Keefe; P Overlie; B Donohue; N Chelliah; G C Timmis Journal: N Engl J Med Date: 1993-03-11 Impact factor: 91.245
Authors: J L Rouleau; L A Moyé; M A Pfeffer; J M Arnold; V Bernstein; T E Cuddy; G R Dagenais; E M Geltman; S Goldman; D Gordon Journal: N Engl J Med Date: 1993-03-18 Impact factor: 91.245
Authors: A M Lincoff; R M Califf; S G Ellis; K N Sigmon; K L Lee; J D Leimberger; E J Topol Journal: J Am Coll Cardiol Date: 1993-12 Impact factor: 24.094
Authors: R J Goldberg; E J Gorak; J Yarzebski; D W Hosmer; P Dalen; J M Gore; J S Alpert; J E Dalen Journal: Circulation Date: 1993-06 Impact factor: 29.690
Authors: Luis Eduardo Juárez-Orozco; Julius Glauche; Erick Alexanderson; Clark J Zeebregts; Hendrikus H Boersma; Andor W J M Glaudemans; Rudi A Dierckx; Dirk J van Veldhuisen; René A Tio; Riemer H J A Slart Journal: Eur J Nucl Med Mol Imaging Date: 2013-04-04 Impact factor: 9.236
Authors: Riemer H J A Slart; Julius Glauche; Reza Golestani; Clark J Zeebregts; Jan W Jansen; Rudi A J O Dierckx; Matthijs Oudkerk; Tineke P Willems; Andor W J M Glaudemans; Hendrikus H Boersma; René A Tio Journal: Eur J Nucl Med Mol Imaging Date: 2012-03-13 Impact factor: 9.236