Long-term prognosis of patients with suspected myocardial infarction confirmed and not confirmed by diagnosis
Launbjerg, J.; Fruergaard, P.; Jacobsen, H.L.; Madsen, J.K.
Ugeskrift for Laeger 155(48): 3917-3920
1993
ISSN/ISBN: 0041-5782 PMID: 8273198 Document Number: 422069
This study prospectively evaluates the long-term prognosis of patients admitted with chest pain under suspicion of acute myocardial infarction (AMI) with and without confirmed diagnosis. Altogether 275 patients with and 257 patients without confirmed AMI (non-AMI) were consecutively included. During seven years of follow-up 122 cardiac events occurred in the AMI patients (i.e. 96 cardiac deaths and 26 nonfatal-AMI), and 69, occurred in the non-AMI patients (44 cardiac deaths and 25 non-fatal AMI). In multivariate Cox-analysis the following risk factors contained independent prognostic information for non-AMI patients: 1) a history of angina pectoris and 2) ST or T changes in the ECG on admission. In patients with AMI the risk factors were 1) previous AMI and 2) clinical heart failure. We conclude that a subset of non-AMI patients who have an increased long-term risk of cardiac events, can be identified from the medical history and the ECG at admission. These patients should be carefully evaluated prior to discharge.