[Differences in prediction of mortality and non-fatal complications after acute myocardial infarction: a multivariate...

The global prognostic after acute myocardial infarction depends of the left ventricular function and the residual ischemia. However, there is controversy about the capacity of some variables reflecting this prognostic factors to predict futures complications. The main objective of this study is to know the influence of the kind of complications in the prognostic value of the variables more frequently used in the clinical practice. We studied 121 consecutive patients with acute myocardial infarction discharged from hospital. The previous and during acute infarction clinical variables were analyzed. The regional and global left ventricular function was studied by 2D echocardiography. An exercise test symptoms-limited was performed at 3rd week after discharge in 94 patients selected. The patients were followed during selected one year. The first year cardiac mortality rate was 8.6%. In the multivariate, the independent predictors of mortality were: age > 60 years (p = 0.02) and the impossibility to perform exercise test (p = 0.0002). In the univariate analysis the echocardiographic motility score > or = 17, eyection fraction < 35% and Killip class > or = II were also death predictors. Non fatal complications (angina, reinfarction o heart failure) were present in 47 patients (42.3%) of 111 survivors. The ischemic complications were predicted in multivariate analysis only by postinfarction angina (p = 0.0007), and heart failure by eyection fraction < 35% (p = 0.006), previous infarct (p = 0.002) and Killip class (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)