Predictors of early death after acute myocardial infarction: two months follow-up

• Published in: European heart journal Vol. 7; no. 4; p. 305
• Main Authors: Cleempoel, H, Vainsel, H, Bernard, R, Dramaix, M, Lenaers, A, Van Kuyk, M, Ewalenko, M, Hoylaerts, M, de Marneffe, M, Vandenbossche, J L
• Format: Journal Article
• Language: English
• Published: England 01.04.1986
• Subjects: Acute Disease; Adult; Aged; Echocardiography; Electrocardiography; Exercise Test; Follow-Up Studies; Humans; Male; Middle Aged; Monitoring, Physiologic; Myocardial Infarction - diagnosis; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - mortality; Prognosis; Radionuclide Imaging
• ISSN: 0195-668X
• DOI: 10.1093/oxfordjournals.eurheartj.a062068

Clinical variables and the results of non-invasive tests (exercise test, echocardiogram, gated equilibrium radionuclide ventriculography and 24 h ECG) were recorded in a series of 202 patients who left the hospital alive after an acute myocardial infarction. The short term (two months) predictive value of all these data was prospectively assessed by uni- and multi-variate analysis. The best correlation with early death was observed with the variables related to the extent of infarction and left ventricular dysfunction, namely: early clinical signs of heart failure, high peak CK-MB level, complete bundle branch block, increased cardiothoracic ratio on chest X-Ray, number of Mets reached during the stress test, echocardiographic dyskinesia index, and decreased left ventricular ejection fraction as measured by radionuclide ventriculography. Using multi-variate stepwise discriminant analysis, the following independent prognostic factors appeared by order of entry: early clinical signs of heart failure, peak CK-MB level and cardiothoracic ratio on chest X-Ray. These results highlight the short-term predictive value of the data related to left ventricular dysfunction and especially of simple clinical data for patients surviving an acute myocardial infarction.