Factors Associated with Cardiac Death in the Posthospital Phase of Myocardial Infarction

Abstract

During the past ten years various cardiac and epidemiologic studies (1–3) have identified a spectrum of risk factors associated with cardiac death in the posthospital phase of myocardial infarction. A number of multivariate techniques have been utilized for identifying subsets of patients who are at high risk of death in the post-infarction period (4–6). The analytic power of these techniques is limited and these multivariate approaches have provided only minimal insight into the mechanisms responsible for cardiac death in the posthospital phase of myocardial infarction. Beginning in 1973 a prospective longitudinal posthospital follow-up program was initiated in Rochester, New York, for patients discharged alive after recovery from acute myocardial infarction (7). This population serves as the basis for the current study. In this investigation the clinical and follow-up features of 96 cardiac deaths occurring in a 52-month posthospital period are presented and compared with a group of 96 matched control patients who survived. The purpose of this retrospective analysis is to identify the factors associated with cardiac mortality in the posthospital phase of myocardial infarction in order to better understand why post-coronary patients die. Such information should provide a proper data base for the development of more rational and effective secondary prevention programs.