10-YEAR MORTALITY OF PATIENTS ADMITTED TO CORONARY-CARE UNITS WITH AND WITHOUT MYOCARDIAL-INFARCTION - RISK-FACTORS FROM MEDICAL HISTORY AND DIAGNOSIS AT DISCHARGE

The purpose was to evaluate the 10-year mortality in patients with acu te chest pain suspected of myocardial infarction with (AMI) and withou t (non-AMI) confirmed diagnosis and to determine risk factors from the medical history and the diagnosis at discharge. One-thousand eight-hu ndred and ninety-seven non-AMI patients and 1,401 patients with AMI co nsecutively admitted to 1 of 16 coronary care units participating in T he Danish Verapamil Infarction Study were included. During follow-up, 630 deaths occurred among the non-AMI patients and 415 of these could be classified as cardiac deaths. Multivariate analysis identified the following risk factors containing independent prognostic information a bout mortality for non-AMI patients: age, previous AMI, sex, and diabe tes. In patients with AMI the risk factors were: age, previous AMI, cl inical heart failure, diabetes, and angina pectoris. By including the diagnosis at discharge for non-AMI patients in the Cox analysis, the p rognostic significance was compared to the variables from the medical history. Only the diagnoses bronchopneumonia, musculoskeletal disorder s and observatio sine indicatione therapiae added independent prognost ic information. We conclude that non-AMI patients are at high risk for mortal events in the long term. High-risk patients can be identified from their medical history, whereas the diagnosis at discharge only ad ds limited prognostic information. All non-AMI patients should be care fully evaluated regarding coronary artery disease at the time of disch arge in order to improve the risk stratification, treatment and progno sis.