Ten-year mortality amongst patients with a very small or unconfirmed acute myocardial infarction in relation to clinical history, metabolic screening and signs of myocardial ischaemia.
OBJECTIVE
To evaluate the long-term prognosis amongst patients with a very small or unconfirmed acute myocardial infarction (AMI) in relation to clinical history, metabolic screening and signs of myocardial ischaemia at exercise test.


METHODS
Patients with a very small or unconfirmed AMI, aged < 76 years, were selected and given a clinical evaluation, metabolic screening and checked for ischaemia at an exercise test 4 weeks after admittance. The 10-year mortality was related to age, sex, clinical history, body weight, serum (S) cholesterol, S-triglycerides, S-gammaglutamyltranspeptidase (GT), S-glucose and various indices of myocardial ischaemia at exercise test.


RESULTS
In all, 714 patients participated in the evaluation. The median age was 63 years and 33% were women. The overall 10-year mortality was 33%. In univariate analysis, the following factors appeared as risk indicators for death: age (P < 0.0001), a history of previous AMI (P < 0.0001), angina pectoris (P < 0.001), diabetes mellitus (P < 0.0001), congestive heart failure (P < 0.0001), smoking (P = 0.030), S-triglycerides (P < 0.0001), S-gamma GT (P < 0. 0001) and S-glucose (P < 0.0001). In multivariate analysis, the following remained as independent risk indicators for death: age (P < 0.0001), S-gamma GT (P < 0.0001), previous AMI (P < 0.0001), smoking (P < 0.0001) and S-glucose (P = 0.010).


CONCLUSIONS
Amongst patients with a very small or a unconfirmed AMI, factors reflecting their clinical history, including age, a history of AMI and current smoking, as well as factors reflecting their metabolic status, including S-gamma GT and S-glucose, were important predictors for the long-term outcome.
Karlson
B W
BW
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Wiklund
O
O
Hallgren
P
P
Sjölin
M
M
Lindqvist
J
J
Herlitz
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000201:enzymology / Q000401:mortality*; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000201:enzymology / Q000401:mortality*; D012008:Recurrence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood*
D001786:Blood Glucose; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol; D005723:gamma-Glutamyltransferase