[Epidemiology of myocardial infarction in France. One-year survival in the Usik study]

The initial phase of the epidemiological USIK study has recensed data concerning 2,563 patients admitted to hospital for acute myocardial infarction. The second phase of this study has documented the 1 year survival of 2,152 patients (84%). The population comprised 1,533 men and 619 women with a mean age of 67 years. Severe left ventricular dysfunction (LVEF < 35%) was observed in 18% of patients and clinical signs of cardiac failure were present in 35% of patients in the first 5 days of infarction. The mortality was 8.2% at 5 days, 13.2% at 28 days and 19.5% at one year. In multivariate analysis, the principal predictive factor of mortality at 1 year was age (RR = 1.06, p = 0.0001): the mortality increased by 6% per year of age. In survivors 5 days after the onset of infarction, the 1 year prognosis was significantly correlated with age (RR = 1.05, p = 0.0001) and with cardiac failure (LVEF: RR = 1.57, p = 0.0001) and Killip class (RR = 1.66, p = 0.0001). The prescription of an ACE inhibitor or a betablocker in the first 5 days of infarction was associated with a reduction in 1 year mortality of 27% (p = 0.04) and 37% (p = 0.01) respectively. In conclusion, this study has determined the features of patients admitted to the Intensive Care Unit for acute myocardial infarction in France and to identify the factors influencing 1 year survival.