Mortality of myocardial infarction in the PRIMVAC registry.: Prognostic factors

BACKGROUND AND OBJECTIVE: The aim of this study was to determine the mortality due to acute myocardial infarction in the coronary units from Comunidad Valenciana (Spain) and the prognostic factors associated with a higher mortality. PATIENTS AND METHOD: Demographic characteristics, coronary risk factors, electrocardiographic ischemic signs, complications and mortality of patients with acute myocardial infarction admitted in the coronary units were collected. The study period comprised January 1995-December 1999. Death incidence was measured during coronary unit's stay. Factors associated with poor prognosis were analyzed. RESULTS: 10.213 patients entered into the study. Mean age at admission was 65 +/- 12 years. 23.8% were females (76.2% males). Global mortality in coronary units was 13.3%. Independent variables associated with higher mortality were (p < 0.05): advanced age (OR = 1.06[1.05- 1.06]), female sex (OR = 1.45 [1.26-1.66]), diabetes mellitus (OR = 1.53 [1.35-1.74]), previous myocardial infarction (OR = 1.46 [1.23-1.70]), previous angor pectoris (OR = 1.29 [1.13-1.49]) and Q-wave infarction (OR = 1.23 [1.03-1.43]). Factors associated with lower mortality were: hypercholesterolemia (OR = 0.76 [0.66-0.78]), smoking (OR = 0.65 [0.57-0.74]) and thrombolysis (OR = 0.85 [0.78-0.92]). CONCLUSIONS: At present, in the reperfusion therapy era, acute myocardial infarction has a high mortality after coronary unit admission. Several clinical factors are associated with a worse prognosis.