ONE-YEAR PROGNOSIS IN PATIENTS HOSPITALIZED WITH A HISTORY OF UNSTABLE ANGINA-PECTORIS

The prognosis during 1 year of follow-up in 715 patients admitted to o ne single hospital due to suspected acute myocardial infarction (AMI) with a history of unstable angina pectoris immediately preceding hospi talization is described. AMI developed in 192 patients (27%) during th e first three days and in 255 patients (38%) during the first year. Th e mortality during hospitalization was 7% (50 patients) and during 1 y ear 19% (130 patients). Of the nonsurvivors, 54% died of AMI, 28% of c ongestive heart failure, and 200% of cardiogenic shock. Based on simpl e clinical parameters on admission to the emergency room, risk indicat ors for death during the following year could be identified as follows , in the order of significance: high age (p < 0.001), ST-segment depre ssion on admission (p < 0.001), and a history of diabetes mellitus (p < 0.05). At admission to the emergency room, risk indicators for devel opment of AMI during the following year were as follows: initial degre e of suspicion of AMI (p < 0.001), electrocardiographic signs of acute ischemia on admission (p < 0.001), ST-segment elevation on admission (p < 0.01), age (p < 0.05), and lack of a previous history of chronic stable angina pectoris (p < 0.05). We conclude that, among patients ad mitted to hospital due to suspected AMI with a history of unstable ang ina pectoris immediately preceding hospitalization, 38% developed a co nfirmed infarction and 19% died during the following year.