Prognostic factors in myocardial infarction

This study was undertaken to establish the long-term prognosis of the initial attack of myocardial infarction. For this purpose, 285 patients who had their initial attack between 1932 and 1942, and who survived the first two months, were followed until their demise or the end of the study (Jan. 1, 1952). Two-thirds of them were found to have lived over 5 years, two-fifths over 10 years and one-tenth over 15 years. Some of the factors which determine long-term survival were analyzed. The importance of recognizing the presence of a large group of mild cases of myocardial infarction capable of long-term survival is stressed.

The Long-Term Prognosis Following Myocardial Infarction, and Some Factors which Affect It

SUMMARY The clinical results of internal mammary artery implantation in the treatment of coronary artery insufficiency are most encouraging. About 70 per cent of our patients are markedly improved and have returned to work. For cases without angina at rest the mortality rate is low—4.3 per cent. In the experimental animal, the implanted internal mammary artery has been shown to send out large branches in the ventricular myocardium in 71 per cent. These branches are large enough to carry a supply of fresh blood into the heart at a rate as high as 51 c.c. per minute. The pericardial fat pads are used as grafts applied to the surface of the left ventricle to supplement the internal mammary artery revascularization of the left ventricle. The results on our human patients are beginning to parallel very closely the frequency of mammary-coronary anastomosis demonstrated in our animal experiments.

Four years' clinical experience with internal mammary artery implantation in the treatment of human coronary artery insufficiency including additional experimental studies.

Excerpt Recently we have had the opportunity to assess the value of serial electrocardiograms in middle-aged men after acute myocardial infarction. This evaluation was conducted as part of a prospe...

Serial electrocardiograms after myocardial infarction.

Survival of diabetic patients after myocardial infarction.

R ECENTLY we have analyzed the factors concerned with the immediate prognosis in recent myocardial infarction. 1 In this report we wish to present the results of our analysis on the long term prognosis. Of the 572 cases previously reported, 507 were selected for this study. These patients were the ones seen in the hospital during the period from 1940 to 1945, inclusive. They represent 0.48 per cent of the total admissions for these years. The selection of these cases was based on the electrocardiographic findings, correlated with the clinical data and, when available, with the necropsy observations. Considerable reliance was placed on unmistakable signs of recent myocardial infarction in the electrocardiogram. The follow-up observations on these patients were made through private physicians, the hospital outpatient department or direct correspondence with the patients known to be alive. Seventeen of the 507 patients could not be followed. A number of the

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Survival after recent myocardial infarction.

IN 1947, Mintz and Katz1published observations on a large series of patients with recent myocardial infarction and pointed out features of importance in establishing the immediate prognosis. Recently, we2analyzed the factors involved in determining the long term prognosis. During the latter study, a follow-up survey was made on 100 patients who had survived acute myocardial infarction from one to six years. The present report correlates the degree of electrocardiographic restitution following acute infarction with the clinical state of the patient. The necessary data were obtained for 100 patients of the 507 whose cases had previously been reported.2Of these, 84 were interviewed and examined at the hospital; for the remaining 16, follow-up information and electrocardiograms were obtained from the records of their private physicians. In every instance, a new electrocardiogram was taken and interpreted by us. Almost all the patients interviewed were maintained on a

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G. Y. Mills

Papers

Survival after recent myocardial infarction.

MYOCARDIAL INFARCTION: Observations on One Hundred Patients Who Survived up to Six Years