Predictors of In-Hospital Mortality After Acute Myocardial Infarction


ABSTRACT: BACKGROUND: Acute myocardial infarction remains a major cause of adult mortality. A steady decline in the mortality rate appears to be due to a fall in the incidence of acute myocardial infarction, a fall in the case fatality rate, identifying those patients who are at increased risk, and more aggressive prophylactic cardiovascular treatments to prevent it from occurring.OBJECTIVE:To identify, patients who have higher risk of in-hospital mortality after the first acute myocardial infarction. PATIENTS AND METHODS: The hospital mortality for the first acute myocardial infarction (AMI) was evaluated for 112 patients who were admitted to the coronary care unit in Baghdad Teaching Hospital during a total period of six months duration, between March and Sept. 2001. For each patient, history, clinical examination, electrocardiograms, fasting venous plasma glucose were done. RESULTS: Total mortality was 16.1%. The following factors were associated with higher in-hospital mortality: advanced age (more than 65 years), females, diabetic, and clinically evident heart failure. Other variables were not associated with increase or decrease in mortality: hypertension, smoking, admission heart rate, bundle branch block, previous angina pectoris, and the site of the infarction. CONCLUSION: Certain groups of patients tend to have higher mortality; patients older than 60 years, females, diabetic and patients with clinical heart failure. Other factors didn’t affect survival; location of the AMI, the presence of bundle branch block, hypertension, angina pectoris, smoking and the high heart rate on admission.