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Mortality and morbidity during one year of follow‐up in suspected acute myocardial infarction in relation to early diagnosis: experiences from the MIAMI trial
Author(s) -
HERLITZ J.,
KARLSON B. W.,
HJALMARSON Å.
Publication year - 1990
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1990.tb00205.x
Subject(s) - medicine , myocardial infarction , angina , infarction , metoprolol , multivariate analysis , cardiology , surgery
. From a large randomized multicentre trial of metoprolol in suspected acute myocardial infarction ( n = 5778) we report on the outcome during 1 year of follow‐up, in relation to early diagnosis. Patients who developed a confirmed infarction had a 1‐year mortality rate of 12.8%. This was significantly higher than the mortality rate of 6.3% ( P < 0.001) in patients with possible infarction and it was also higher than that in patients with no infarction, which was 5.0% ( P < 0.001). A multivariate analysis showed that independent risk predictors in the clinical history of patients without confirmed infarction were a history of angina pectoris, chronic use of digitalis and advanced age. After 1 year, angina pectoris was most common in patients with an initial possible infarction. These patients were also in most urgent need of bypass surgery. We thus conclude that the mortality during 1 year of follow‐up among patients with an initially strongly suspected acute myocardial infarction was clearly related to whether or not the patient developed a myocardial infarction.