Prediction of sudden death in patients discharged after acute myocardial infarction.

A follow-up was made of 475 patients discharged after an acute myocardial infarction. Sudden death, i.e. death within 2 hours after the onset of the final attack, was more common in patients below 60 years on admission than in the older age groups. Patients succumbing suddenly often had a history of an earlier myocardial infarction. They also had a higher incidence of inferior infarcts and more frequently showed ventricular tachycardia during the early hospital period than those dying more than 24 hours after the onset of the final episode. When comparisons were made with all patients dying after more than 2 hours' duration of the terminal attack no significant differences were noted for these or other parameters. Prediction of sudden death in immediate survivors of acute myocardial infarction thus seems elusive. Further studies of the relations between the incidence of ventricular ectopic activity during the early and late hospital phase of acute myocardial infarction and sudden death after discharge from hospital are implicated.