IMPROVED LONG-TERM PROGNOSIS AFTER MYOCARDIAL-INFARCTION 1984-1991

Aims We set out to examine whether long term prognosis in terms of 2-y ear mortality after myocardial infarction has improved after the intro duction of intravenous betablockers, nitroglycerin infusion? aspirin a nd thrombolytics, in an unselected population of patients hospitalized with a myocardial infarction. Methods and Results We investigated ret rospectively 3791 acute myocardial infarctions in 3187 Goteborg women and men (1039 women and 2148 men)? who were consecutively admitted to the coronary care unit at the Ostra hospital during 1984-1991. Through out this period, data were entered continuously into the coronary care unit database. Mortality data were collected through the Swedish caus e-specific mortality register. The primary endpoint was mortality with in 2 years after the onset of the index infarction. Two-year mortality decreased from 36% in 1983 to 25% in 1991. In a Cox regression model (including myocardial infarctions up to 1993) year of hospitalization, age, diabetes mellitus, sex, prior myocardial infarction and indeterm inable infarct location all had a significant impact on survival after myocardial infarct. Thrombolytic therapy and hypertension had no prog nostic significance. Conclusion Against a background of radical change s in the treatment of acute myocardial infarction during 1984-1991 we have seen decreasing in-hospital mortality as well as a substantial de crease in 2-year mortality.