MORTALITY AND MORBIDITY OF ACUTE MYOCARDI AL-INFARCTION - COMPARISON OF 3 PATIENT COHORTS ADMITTED TO HOSPITAL SEPARATED BY 10-YEAR INTERVALS

The management of acute myocardial infarction has been transformed ove r the last thirty years by a number of therapeutic innovations. The au thors decide to compare the outcomes of three cohorts of unselected pa tients admitted to hospital at 10 year intervals, to evaluate the impa ct of these innovations on morbidity and mortality. Six hundred and si xty one patient admitted to the Coronary Care Unit for acute myocardia l infarction were included : Group I comprised 223 patients admitted c onsecutively during the period 1972-1973; Group II comprised 243 patie nts admitted between 1982-1983 and Group III comprised 195 patients ad mitted between 1992-1993. The average age was comparable, about 65 yea rs, in the 3 groups, although there were gender differences. Taking in to consideration earlier hospital admission, the in-hospital mortality decreased from 25 % in Group I to 21.8 % in Group II and to 15.4 % in Group III (p < 0.05 between the first 2 groups and the third group). This decrease in mortality is even greater in anterior wall infarction and is observed in all ages. Similarly to selected patients in large scale randomised clinical trials, the ordinary ''run of the mill'' pat ient has also benefited from therapeutic innovations over the last ten years.