Long-term prognosis of patients with acute myocardial infarction: is mortality and morbidity as low as the incidence of ischemic heart disease in Japan

Abstract

Long-term prognosis of hospital survivors with myocardial infarction (MI) was investigated to assess the validity of previous reports on the low incidence of ischemic heart disease in Japan. Among 686 patients with acute MI, 115 (16.8%) died during hospitalization and eight were lost to follow-up. The cumulative mortality rate of the 563 hospital survivors was 6.2% in the first year, 12.0% in the third year, and 19.1% in the fifth year, with cardiac death accounting for 63% of the deaths. Cumulative rates for recurrent MI were 4.4% in the first year, 11.0% in the third year, and 13.2% in the fifth year. Parameters influencing long-term mortality rates obtained by stepwise discriminant analysis were arteriosclerosis-related factors, presence of congestive heart failure at admission, age, and presence of previous MI, while parameters influencing the recurrence of MI were congestive heart failure, arteriosclerosis-related factors, and ischemic findings at discharge. Our findings indicate that the prognosis for patients with MI is far better in Japan than in Western countries and support the previous reports on the low incidence of ischemic heart disease in Japan, while factors influencing the prognosis are similar to those previously reported.