Long-term follow-up of acute myocardial infarction: risk factors for long-term prognosis

Objective: To analyze risk factors for long term prognosis in pts with AMI.Methods: Ninety one pts who underwent coronary angiography and echocardiography during hospitalization from 1988~1995 were followed The investigation was carried out mainly by seeing the pts at outpatient clinic The pts or their family were carefully asked about any major cardiac events occurring after the first AMI,which included death,non fatal AMI,revascularization procedures,heart failure,and severe angina Echocardiography was repeated at the follow up If the pts were unable to come to the hospital,the investigator would ring the pts or their family.Results: 1.Fifteen pts （20.8%） died at the end of 10.year follow up Life table showed that 10% of the pts died in the acute phase of AMI,10% died within 5~6 years,and 10% died 5~10.years The 10.year survival rate was about 70% 2 Smoking,acute heart failure,LVEF in acute phase,LV end diastolic diameter（LVED） at the follow up,NYHA class were significant risk factors for death,P＜ 0.05 or 0.001 3 The patency of infarct related artery（IRA）,LVEF at the follow up,NYHA class were significant risk factors for severe angina（≥3 CCS class）,P＜0.005 or 0.001 The number of diseased vessel was close to significance （P=0.06） 4 IRA patency,LVEF and LVED in acute phase,CCS class were significant risk factors for severe left heart failure（NYHA class ≥3）,P＜0.005 5 LVED increased and LVEF decreased significantly during follow up,P＜0.005.Conclusion: IRA patency,LVEF,LVED,NYHA class,CCS class are important determinants of long term prognosis LV function deteriorates significantly after the acute phase.