[Prognosis in complications of acute myocardial infarction requiring artificial respiration]

From 1978 to 1981, 818 consecutive patients with acute myocardial infarction were admitted, 112 (13.7%) of whom required artificial ventilation because of complications. Their mean age (62) corresponded to the mean age of all acute myocardial infarction patients (63). 28 (25%) survived the hospitalization and were followed after discharge. 2 were lost to follow-up. After a mean follow-up period of 26 months, 8 patients had died and 18 were still alive, none of them free of symptoms. There was no difference of age, duration of respirator therapy and maximal creatine kinase activity between survivors (group A) and nonsurvivors (group B). In 50% of patients cardiac failure leading to endotracheal intubation was triggered or made worse by arrhythmias. The remaining 50% of patients showed pure pump failure. Again in these two subsets, cardiac failure was significantly less marked in group A than in group B according to the hemodynamic findings. In conclusion, inpatient mortality in patients with acute myocardial infarction requiring artificial ventilation was high (75%) and hemodynamic findings were significantly worse in those not surviving. Patients discharged from the hospital also had a reduced life expectancy (less than 50% after 3 years).