10-YEAR MORTALITY IN PATIENTS WITH SUSPECTED ACUTE MYOCARDIAL-INFARCTION

Objective-To describe the 10 year mortality in patients with suspected acute myocardial infarction. Design-Follow up of all patients below 7 6 years of age admitted with acute chest pain to 16 coronary care unit s participating in the Danish verapamil infarction trial in 1979-81. S ubjects-Of the 5993 patients included, 2586 had definite infarction, 4 02 had probable infarction, and 3005 did not have infarction. Main out come measures-Death and cause of death. Standardised mortality ratio ( observed mortality/expected mortality in background population). Resul ts-The estimated 10 year mortalities were 58.8%, 55.5%, and 42.8% in p atients with definite, probable, and no infarction, respectively (P<0. 0001). Stratified Cox's analysis identified a hazard ratio for mortali ty of 1.25 (95% confidence interval 1.08 to 1.44) for probable infarct ion compared with no infarction and of 1.15 (1.00 to 1.32) for definit e compared with probable infarction. The standardised mortality ratio in the first year was 7.1 (6.5 to 7.8) for definite infarction, 5.0 (3 .6 to 6.3) for probable infarction, and 4.7 (4.2 to 5.2) for no infarc tion. From the second year and onwards the annual standardised mortali ty ratio in the three groups did not differ significantly. Cardiac cau ses of deaths were recorded in 89%, 84%, and 71% of the deaths in pati ents with definite, probable, and no infarction, respectively. Conclus ions-The 10 year mortality of patients with and without infarction is significantly higher than in the background population. Most deaths ar e caused by coronary heart disease, and these patients should conseque ntly be further evaluated at the time of discharge and followed up clo sely.