Predictors of non-fatal ischemic events after myocardial infarction.
We characterize predictors of reinfarction and angina in 403 consecutive men aged 60 years or less who underwent heart catheterization within one month (18 +/- 6 days) after a qualifying myocardial infarction. Angiography showed obstructive lesions (greater than or equal to 50% diameter reduction) in 380 patients. One-, two- and three-vessel disease was found in 143 (36%), 139 (35%) and 98 (29%) patients, respectively. After 57 months of follow-up there were 60 deaths (12%), 41 patients (10%) sustained a new infarction and 210 (52%) had angina. Cox regression analysis selected the number of diseased vessels as the only independent 'predictor of reinfarction; independent predictors of angina were the number of diseased vessels and a history of angina prior to the qualifying infarction. Risk stratification showed the probability of reinfarction at 6 years to be significantly lower (P less than 0.001) in patients with one-vessel disease (12%) than in those with two- (30%) and three-vessel disease (37%). Similarly the probability of angina was also lower (P less than 0.001) in patients with one-vessel disease (51%) as compared to those with two- (72%) and three-(74%) vessel involvement. Thus multi-vessel disease is the main predictor of new non-fatal ischemic events after myocardial infarction.
Sanz
G
G
Cardiac Unit, Hospital Clinic, University of Barcelona, Spain.
Betriu
A
A
Castañer
A
A
Roig
E
E
Heras
M
M
Magriñá
J
J
Paré
C
C
Navarro-López
F
F
D000787:Angina Pectoris / Q000209:etiology*; D000792:Angiography; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors