Long-term prognosis after recovery from myocardial infarction: A community-based survey in Yamagata, Japan

Objective To assess the long-term prognosis after recovery from acute myoca rdial infarction (AMI) in the general population in Japan. Patients and Methods Among the 575,000 inhabitants of the Yamagata metropol itan area, a total of 117 patients suffered from first their AMI from April to December 1993. Thirteen patients (11%) died within four weeks after the onset. Of the remaining 104 patients, 101 (mean age, 69 +/- 12 years) were followed for an average of 65 +/-5 months. Results Twenty-seven of the 101 patients (27%) died during the follow-up pe riod. Compared with survivors, the patients who died were significantly old er at the onset of AMI (74 +/- 12 vs. 67 +/- 12 years, p <0.01). More diabe tic patients than non-diabetic patients died (42 vs. 21%, p <0.05) because of the higher frequency of non-cardiac deaths (29 vs. 11%, p <0.05). The to tal number of deaths of cardiac origin, including sudden deaths, was 11 (40 %) and was lower than the number of definite non-cardiac deaths (n=15). The time from the onset of AMI to death was significantly shorter in cases of cardiac death than in cases of non-cardiac death (median, 16 vs. 45 months, p <0.01). Among non-cardiac deaths, deaths due to lung cancer and cerebral infarction were notable in men (standardized mortality ratio 278) and wome n (571), respectively. Conclusion Non-cardiac death during long-term follow-up after AMI was more frequent than death of cardiac origin. Thus, preventive measures, including early treatment of complicating diseases, must be implemented to improve t he long-term prognosis of patients with myocardial infarction.