LONG-TERM PROGNOSIS AFTER MYOCARDIAL-INFARCTION - UNIVARIATE AND MULTIVARIATE-ANALYSIS OF CLINICAL CHARACTERISTICS IN 1,000 PATIENTS

To examine the clinical outcome for patients with myocardial infarctio n and to analyze clinical predictors for longterm prognosis, 1,000 pat ients were studied retrospectively. Between January 1983 and December 1987, 1,002 consecutive patients with myocardial infarction, who resid ed in the Kyoto and Shiga districts, were reviewed after coronary arte riography, but in two patients medical records were not located. Durin g 3.3 +/- 2.0 years, 75 patients died of cardiac causes and 301 ex per ienced cardiac events (death, reinfarction, and revascularization). Ov erall 5-year cardiac mortality was 8% and cardiac event rate was 35%. Among determinants of age, smoking, hypertension, diabetes mellitus, h eart failure, postinfarction angina, serious arrhythmia, mitral regurg itation, digitalis and diuretics administration, ejection fraction (EF ), left main trunk disease, and number of diseased coronary arteries s elected by univariate analysis, multivariate analysis revealed that he art failure, EF, number of coronary vessel disease, diabetes, and mitr al regurgitation were the important predictors of cardiac death. For c ardiac events, multivariate analysis demonstrated that the number of d iseased coronaries, postinfarction angina and left main trunk disease were significant predictors. Therefore, impaired left ventricular func tion and myocardial ischemia appear to be important markers for cardia c death, but impaired left ventricular function does not appear to be a predictor for cardiac events. The data obtained in this study will b e useful in the assessment of patients with myocardial infarction and will be of clinical significance in predicting mortality and cardiac e vents.