LONG-TERM PROGNOSIS OF MEDICALLY TREATED PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION AND ONE-VESSEL CORONARY-ARTERY DISEASE

Long-term prognosis was studied in 156 patients with acute myocardial infarction (AMI) with 1-vessel coronary artery disease (CAD). During a mean follow-up period of 110 months, 19 patients (14%) had reinfarcti on, 15 (9.6%) died (including 7 deaths of cardiac origin) and 15 (9.6% ) were hospitalized for worsening of angina. A coronary arteriogram wa s obtained twice in 54 patients. The coronary arteriogram revealed mul tivessel CAD in all cases with reinfarction (n = 14). Ten percent of t he patients with multivessel disease experienced a reinfarction during the initial 3 years after the onset of the first AMI. The recurrence rate of AMI in patients with 1-vessel disease increased gradually from the third year after the onset of their first AMI, reaching 10% in 6. 7 years. The recurrence of AMI at the same region as the original infa rction was detected in only 1 patient. Six of 19 patients (32%) with r ecurrence of AMI died and 13 survived after the reinfarction. It was d ifficult to predict future progression from the outcome of the compari son between the first and second coronary arteriograms. Thus, in patie nts with uncomplicated AMI with 1-vessel CAD, the prognosis is relativ ely good and the frequency of reinfarction is very low with conservati ve treatment.