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.