PREDICTORS AND MODE OF DEATH OVER 5 YEARS AMONGST PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT WITH ACUTE CHEST PAIN OR OTHER SYMPTOMS RAISING SUSPICION OF ACUTE MYOCARDIAL-INFARCTION

Aim. To describe the mortality and mode of death over 5 years, and fac tors associated with death amongst patients with acute chest pain. Pat ients. All patients who came to the emergency department at Sahlgrensk a Hospital in Goteborg with acute chest pain or other symptoms raising suspicion of acute myocardial infarction (AMI) during a 21-month peri od. Results. In all, 5241 patients were evaluated, of whom 1345 (26%) died during the 5 years of follow-up. The following factors were indep endent predictors of an increased risk of death: age (P < 0.001); male sex (P < 0.001); symptoms of acute congestive heart failure (P < 0.00 1) or unspecific symptoms on admission (P < 0.05); smoking (P < 0.001) ; a history of either congestive heart failure (P < 0.001), diabetes m ellitus (P < 0.001), previous myocardial infarction (P < 0.001) or hyp ertension (P < 0.05); initial degree of suspicion of AMI (P < 0.001) a nd presence of pathological electrocardiogram (P < 0.001) on admission to hospital. Amongst patients who died, 66% died a cardiac death and 35% died in association with a myocardial infarction. Conclusion, Amon gst patients admitted to the emergency department due to chest pain or other symptoms raising suspicion of AMI, several predictors based on clinical history and clinical presentation can be denied, which are st rongly related to the long-term prognosis.