LONG-TERM PROGNOSIS OF PATIENTS AFTER A Q-WAVE COMPARED WITH A NON-Q-WAVE FIRST ACUTE MYOCARDIAL-INFARCTION - DATA FROM THE SPRINT REGISTRY

Objective, design and patients Between August 1981 and July 1983, 5839 consecutive myocardial infarction patients were hospitalized in 13 co ronary care units in Israel. The present study examines 10 year surviv al among 4037 consecutive patients with a first myocardial infarction with either Q or non-Q waves. Demographic and medical data were collec ted from hospital records. and 1 year clinical follow-up was complete for 99%, of hospital survivors. Mortality follow-up was extended to Ju ne 1992 (mean 10 years of follow-up). Results Five hundred and eighty patients (14%) had first myocardial infarctions of the non-Q wave type and 3457 of the Q wave type. Hospital mortality was significantly hig her in patients with a Q wave (10%) than those with a non-Q wave myoca rdial infarction (7%) (P<0 . 05). One year postdischarge, non-fatal re infarction and mortality rates were comparable in patients with Q wave (4% and 7%) and non-Q wave myocardial infarctions (4% and 7% respecti vely). Similarly, 5 to 10 year post-discharge mortality rates were equ ally high in patients with a non-Q wave (26% and 44%) as in those with a first episode of a Q wave myocardial infarction (22% and 40% respec tively). Conclusions Patients with a first non-Q wave acute myocardial infarction exhibited relatively better in-hospital survival than coun terparts with a first Q wave infarction, but the advantage did not per sist after discharge. Patients with a non-Q wave infarction deserve pa rticular attention as their post-discharge mortality risk is similar t o counterparts with a first Q wave myocardial infarction.