Coronary anatomy and prognosis after myocardial infarction in patients 60 years of age and younger.

Two hundred twenty-nine hospital survivors of acute myocardial infarction (MI) age 60 years or younger underwent coronary arteriography a median of 2 weeks after infarction and were followed a median of 24 months (range 6-62 months). For 62%, MI was the first presentation of coronary disease and 75% were in clinical Killip class I. Overall outcome was good: 96% survival at 1 year and 95% survival at 2 years. This was due to the high prevalence of patients with one-vessel disease (58%), with a survival of 99% at 1 year and 96% at 2 years. Only 9% of patients had three-vessel disease and they had an 85% survival at 1 year. Eleven patients died and 23 had coronary bypass surgery. In this cohort of younger patients (mean age 51 years), prophylactic therapy may not be justified because of the low mortality and should be reserved for identifiable high-risk groups.