Prediction of cardiovascular deaths and non-fatal reinfarctions after myocardial infarction.

The present study concerns the development and validation of a logistic multivariate prognostic function in patients followed for two years after myocardial infarction. The patients studied constituted at least 90% of all cases in a total community--the City of Göteborg, Sweden. Using a multivariate logistic function with 7 variables, based on 30 cardiovascular deaths during two years after discharge from hospital among 292 men with first infarction, breathlessness at onset of symptoms of infarction, SGOT quartile, left heart failure, relative heart size, atrial fibrillation, a history of hypertension, and AV block recorded during the hospital phase were the most important variables. The first five of these variables made significant contributions (p less than 0.01) to the predictive power. The predictive capacity was confirmed in an independent series of 195 men with first infarction, among whom 17 cardiovascular deaths occurred. Around 60% of the total cardiovascular mortality was concentrated in the highest risk quintile. Deaths from non-cardiovascular causes were predicted less efficiently. Non-fatal recurrences could not be predicted by the present model. Thus, the function can predict the excess risk of mortality but not the excess risk of reinfarction during two years among men after an initial myocardial infarction.