Characteristics associated with early (less than or equal to 3 months) versus late (greater than 3 months to less than or equal to 3 years) mortality after acute myocardial infarction.
To define the independent variables predictive of early versus late mortality after acute myocardial infarction (AMI), 420 consecutive patients were studied and divided into 3 groups: the 45 patients who died within the initial 3 months (group 1), the 45 patients who died greater than 3 months and less than or equal to 3 years after AMI (group 2) and the 330 greater than 3-year survivors (group 3). The stepwise logistic discrimination method was applied to clinical and laboratory variables recorded during hospitalization to distinguish among the 3 groups. Six independent variables were found to be predictive of early mortality: left ventricular function score (chi-square 26.2; p less than 0.00001), ventricular fibrillation (chi-square 9.3; p = 0.002), bundle branch block (chi-square 9.0; p = 0.003), history of previous AMI (chi-square 8.7; p = 0.003), age (chi-square 5.8; p = 0.02) and atrioventricular block (chi-square 3.8; p = 0.05). Three independent variables were found predictive of late mortality: age (chi-square 13.8; p = 0.0002), anterior location of the AMI (chi-square 4.0; p = 0.04) and a low peak creatine kinase-MB level (chi-square 3.8; p = 0.05). Only 2 variables were able to distinguish between early and late nonsurvivors: peak creatine kinase-MB level (chi-square 8.7; p = 0.003) and ventricular fibrillation (chi-square 4.6; p = 0.03). Thus, the sets of independent risk factors for early and late mortality after AMI are substantially different--suggesting that differing mechanisms are responsible for outcome.
Piérard
L A
LA
Department of Medicine, University Hospital, Liège, Belgium.
Chapelle
J P
JP
Albert
A
A
Dubois
C
C
Kulbertus
H E
HE
D000367:Age Factors; D002037:Bundle-Branch Block / Q000401:mortality; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012307:Risk Factors; D013223:Statistics as Topic; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000401:mortality
D007527:Isoenzymes; D003402:Creatine Kinase