SURVIVORSHIP PATTERNS IN THE POST-HOSPITAL PHASE OF MYOCARDIAL-INFARCTION

被引:183
作者
DAVIS, HT
DECAMILLA, J
BAYER, LW
MOSS, AJ
机构
[1] UNIV ROCHESTER,DEPT PREVENT MED & COMMUNITY HLTH,HEART RES FOLLOWUP PROGRAM,ROCHESTER,NY 14627
[2] UNIV ROCHESTER,SCH MED & DENT,DEPT MED,DIV BIOSTAT,ROCHESTER,NY 14627
关键词
D O I
10.1161/01.CIR.60.6.1252
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A prospective postinfarction follow-up study was used to identify subsets of patients with different survival patterns. Nine hundred forty patients who survived the hospital phase of an acute myocardial infarction were followed for 12-60 months. During the 5-year follow-up, 115 patients died of cardiac causes. Univariate analysis showed that prior myocardial infarction (PMI), left ventricular dysfunction (LVD) in the CCU, one or more ventricular premature depolarizations (VPDs) on a 6-hour Holter recording, and anterior myocardial infarction were significantly (p<0.01) more frequent in patients who died of cardiac causes than in survivors. Survivorship analyses revealed a variety of survival patterns, depending on the presence or absence of the risk factors PMI, LVD, VPD and anterior infarction, as well as their interactive combinations. A combinatin of anterior infarction with LVD and VPDs identified a high-risk subset that made up 15% of the myocardial infarction population, and this group had 6-month and 3-year survival rates of 85% and 70%, respectively. After we excluded the high-risk subset, PMI, LVD and VPD each had significant yet independent influence on survival, with PMI having a greater effect on mortality than either LVD or VPDs. A low-risk subset that made up 24% of the population was identified by the absence of PMI, LVD and VPDs, and this group had a 3-year survival of 94%.
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页码:1252 / 1258
页数:7
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