LONG-TERM PROGNOSTIC IMPORTANCE OF A SINGLE PULMONARY WEDGE PRESSURE MEASUREMENT AFTER MYOCARDIAL-INFARCTION - A 10-YEAR FOLLOW-UP-STUDY

To assess the influence on short- and long-term survival of haemodynam ic variables measured after acute myocardial infarction, a 10-year pro spective follow-up study was undertaken. A total of 304 patients (259 males, 45 females) discharged from hospital after myocardial infarctio n and under 66 years of age were studied. Haemodynamic variables measu red shortly after admittance included pulmonary wedge pressure, mixed venous oxygen saturation, blood pressure and heart rate. In the analys is, adjustments were made for differences in age, gender, clinical par ameters and cardiovascular risk factors. Pulmonary wedge pressure was found to be a strong and independent predictor of both short-term and long-term survival. A gradual increase of the 10-year mortality risk w ith elevated wedge pressure could be demonstrated (relative risk, 1.09 /mmHg; 95% confidence interval, 1.04-1.15). Relative risks of patients in the three highest categories of wedge pressure, 12-15 mmHg, 15-19 mmHg and 19 mmHg and higher, compared with patients in the lowest cate gory, lower than 12 mmHg, were 2.25 (95% CI, 1.11-4.55), 2.43 (95% CI, 1.20-4.92) and 2.57 (95% CI, 1.04-6.37), respectively. The other meas ured haemodynamic variables were found to be associated with short-ter m mortality only. In conclusion, haemodynamic measurements after myoca rdial infarction are of prognostic importance after discharge. A singl e measurement of an elevated wedge pressure in particular unfavourably influenced both short-term and long-term survival.