Abstract
In the past 20 years there has been a steady improvement in the short term prognosis of patients with myocardial infarction, following the introduction of beta blockers, thrombolysis, and aspirin. Patients treated with thrombolytic drugs have a lower overall mortality after myocardial infarction but remain at risk of non-fatal reinfarction or death, and in one study almost half of all survivors of acute myocardial infarction died or suffered a further ischaemic event within three years. It is therefore important to have a strategy to identify patients at high risk, to reduce the subsequent development of cardiac failure and mortality, and to have effective measures for secondary prevention to reduce the incidence of reinfarction as well as to promote rehabilitation.
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Selected References
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- Arnold A. E., Simoons M. L., Detry J. M., von Essen R., Van de Werf F., Deckers J. W., Lubsen J., Verstraete M. Prediction of mortality following hospital discharge after thrombolysis for acute myocardial infarction: is there a need for coronary angiography? European Cooperative Study Group. Eur Heart J. 1993 Mar;14(3):306–315. doi: 10.1093/eurheartj/14.3.306. [DOI] [PubMed] [Google Scholar]
- Betteridge D. J., Dodson P. M., Durrington P. N., Hughes E. A., Laker M. F., Nicholls D. P., Rees J. A., Seymour C. A., Thompson G. R., Winder A. F. Management of hyperlipidaemia: guidelines of the British Hyperlipidaemia Association. Postgrad Med J. 1993 May;69(811):359–369. doi: 10.1136/pgmj.69.811.359. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bigger J. T., Jr, Fleiss J. L., Kleiger R., Miller J. P., Rolnitzky L. M. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984 Feb;69(2):250–258. doi: 10.1161/01.cir.69.2.250. [DOI] [PubMed] [Google Scholar]
- Burr M. L., Fehily A. M., Gilbert J. F., Rogers S., Holliday R. M., Sweetnam P. M., Elwood P. C., Deadman N. M. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet. 1989 Sep 30;2(8666):757–761. doi: 10.1016/s0140-6736(89)90828-3. [DOI] [PubMed] [Google Scholar]
- Ceremuzynski L., Kleczar E., Krzeminska-Pakula M., Kuch J., Nartowicz E., Smielak-Korombel J., Dyduszynski A., Maciejewicz J., Zaleska T., Lazarczyk-Kedzia E. Effect of amiodarone on mortality after myocardial infarction: a double-blind, placebo-controlled, pilot study. J Am Coll Cardiol. 1992 Nov 1;20(5):1056–1062. doi: 10.1016/0735-1097(92)90357-s. [DOI] [PubMed] [Google Scholar]
- Chadda K., Goldstein S., Byington R., Curb J. D. Effect of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation. 1986 Mar;73(3):503–510. doi: 10.1161/01.cir.73.3.503. [DOI] [PubMed] [Google Scholar]
- Cooper A. J. Myocardial infarction and advice on sexual activity. Practitioner. 1985 Jun;229(1404):575–579. [PubMed] [Google Scholar]
- Cross S. J., Lee H. S., Kenmure A., Walton S., Jennings K. First myocardial infarction in patients under 60 years old: the role of exercise tests and symptoms in deciding whom to catheterise. Br Heart J. 1993 Nov;70(5):428–432. doi: 10.1136/hrt.70.5.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Daly L. E., Graham I. M., Hickey N., Mulcahy R. Does stopping smoking delay onset of angina after infarction? Br Med J (Clin Res Ed) 1985 Oct 5;291(6500):935–937. doi: 10.1136/bmj.291.6500.935. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farrell T. G., Bashir Y., Cripps T., Malik M., Poloniecki J., Bennett E. D., Ward D. E., Camm A. J. Risk stratification for arrhythmic events in postinfarction patients based on heart rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram. J Am Coll Cardiol. 1991 Sep;18(3):687–697. doi: 10.1016/0735-1097(91)90791-7. [DOI] [PubMed] [Google Scholar]
- Friedman M., Thoresen C. E., Gill J. J., Ulmer D., Powell L. H., Price V. A., Brown B., Thompson L., Rabin D. D., Breall W. S. Alteration of type A behavior and its effect on cardiac recurrences in post myocardial infarction patients: summary results of the recurrent coronary prevention project. Am Heart J. 1986 Oct;112(4):653–665. doi: 10.1016/0002-8703(86)90458-8. [DOI] [PubMed] [Google Scholar]
- Held P. H., Yusuf S., Furberg C. D. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ. 1989 Nov 11;299(6709):1187–1192. doi: 10.1136/bmj.299.6709.1187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jennings K., Reid D. S., Hawkins T., Julian D. J. Role of exercise testing early after myocardial infarction in identifying candidates for coronary surgery. Br Med J (Clin Res Ed) 1984 Jan 21;288(6412):185–187. doi: 10.1136/bmj.288.6412.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Killip T., 3rd, Kimball J. T. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol. 1967 Oct;20(4):457–464. doi: 10.1016/0002-9149(67)90023-9. [DOI] [PubMed] [Google Scholar]
- Kleiger R. E., Miller J. P., Bigger J. T., Jr, Moss A. J. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987 Feb 1;59(4):256–262. doi: 10.1016/0002-9149(87)90795-8. [DOI] [PubMed] [Google Scholar]
- La Rovere M. T., Specchia G., Mortara A., Schwartz P. J. Baroreflex sensitivity, clinical correlates, and cardiovascular mortality among patients with a first myocardial infarction. A prospective study. Circulation. 1988 Oct;78(4):816–824. doi: 10.1161/01.cir.78.4.816. [DOI] [PubMed] [Google Scholar]
- Lewin B., Robertson I. H., Cay E. L., Irving J. B., Campbell M. Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services. Lancet. 1992 Apr 25;339(8800):1036–1040. doi: 10.1016/0140-6736(92)90547-g. [DOI] [PubMed] [Google Scholar]
- Lim R., Dymond D. S. Should antianginal medication be stopped for exercise testing? Lancet. 1992 Jul 18;340(8812):161–162. doi: 10.1016/0140-6736(92)93226-d. [DOI] [PubMed] [Google Scholar]
- Maggioni A. P., Zuanetti G., Franzosi M. G., Rovelli F., Santoro E., Staszewsky L., Tavazzi L., Tognoni G. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation. 1993 Feb;87(2):312–322. doi: 10.1161/01.cir.87.2.312. [DOI] [PubMed] [Google Scholar]
- Marmot M. G., Rose G., Shipley M. J., Thomas B. J. Alcohol and mortality: a U-shaped curve. Lancet. 1981 Mar 14;1(8220 Pt 1):580–583. doi: 10.1016/s0140-6736(81)92032-8. [DOI] [PubMed] [Google Scholar]
- Morgan C. D., Roberts R. S., Haq A., Baigrie R. S., Daly P. A., Gent M., Armstrong P. W. Coronary patency, infarct size and left ventricular function after thrombolytic therapy for acute myocardial infarction: results from the tissue plasminogen activator: Toronto (TPAT) placebo-controlled trial. TPAT Study Group. J Am Coll Cardiol. 1991 Jun;17(7):1451–1457. doi: 10.1016/0735-1097(91)90630-r. [DOI] [PubMed] [Google Scholar]
- Moss A. J., Benhorin J. Prognosis and management after a first myocardial infarction. N Engl J Med. 1990 Mar 15;322(11):743–753. doi: 10.1056/NEJM199003153221107. [DOI] [PubMed] [Google Scholar]
- Moss A. J., Goldstein R. E., Hall W. J., Bigger J. T., Jr, Fleiss J. L., Greenberg H., Bodenheimer M., Krone R. J., Marcus F. I., Wackers F. J. Detection and significance of myocardial ischemia in stable patients after recovery from an acute coronary event. Multicenter Myocardial Ischemia Research Group. JAMA. 1993 May 12;269(18):2379–2385. [PubMed] [Google Scholar]
- Muir K. W., Rodger J. C., DeBono J. S., McDonald H., Irving J. B. Drugs and the exercise test. BMJ. 1992 Oct 3;305(6857):808–809. doi: 10.1136/bmj.305.6857.808-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murray R. G. Which patients should have exercise testing after myocardial infarction treated by thrombolysis? Br Heart J. 1993 Nov;70(5):399–399. doi: 10.1136/hrt.70.5.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Norris R. M., Caughey D. E., Deeming L. W., Mercer C. J., Scott P. J. Coronary prognostic index for predicting survival after recovery from acute myocardial infarction. Lancet. 1970 Sep 5;2(7671):485–487. doi: 10.1016/s0140-6736(70)90110-8. [DOI] [PubMed] [Google Scholar]
- Oldridge N. B., Guyatt G. H., Fischer M. E., Rimm A. A. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA. 1988 Aug 19;260(7):945–950. [PubMed] [Google Scholar]
- Olsson G., Odén A., Johansson L., Sjögren A., Rehnqvist N. Prognosis after withdrawal of chronic postinfarction metoprolol treatment: a 2-7 year follow-up. Eur Heart J. 1988 Apr;9(4):365–372. doi: 10.1093/oxfordjournals.eurheartj.a062512. [DOI] [PubMed] [Google Scholar]
- Piccalò G., Pirelli S., Massa D., Cipriani M., Sarullo F. M., De Vita C. Value of negative predischarge exercise testing in identifying patients at low risk after acute myocardial infarction treated by systemic thrombolysis. Am J Cardiol. 1992 Jul 1;70(1):31–33. doi: 10.1016/0002-9149(92)91385-h. [DOI] [PubMed] [Google Scholar]
- Roubin G. S., Harris P. J., Bernstein L., Kelly D. T. Coronary anatomy and prognosis after myocardial infarction in patients 60 years of age and younger. Circulation. 1983 Apr;67(4):743–749. doi: 10.1161/01.cir.67.4.743. [DOI] [PubMed] [Google Scholar]
- Simson M. B. Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation. 1981 Aug;64(2):235–242. doi: 10.1161/01.cir.64.2.235. [DOI] [PubMed] [Google Scholar]
- Smith G. D., Song F., Sheldon T. A. Cholesterol lowering and mortality: the importance of considering initial level of risk. BMJ. 1993 May 22;306(6889):1367–1373. doi: 10.1136/bmj.306.6889.1367. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith P., Arnesen H., Holme I. The effect of warfarin on mortality and reinfarction after myocardial infarction. N Engl J Med. 1990 Jul 19;323(3):147–152. doi: 10.1056/NEJM199007193230302. [DOI] [PubMed] [Google Scholar]
- Stevenson R., Ranjadayalan K., Wilkinson P., Roberts R., Timmis A. D. Short and long term prognosis of acute myocardial infarction since introduction of thrombolysis. BMJ. 1993 Aug 7;307(6900):349–353. doi: 10.1136/bmj.307.6900.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stevenson R., Umachandran V., Ranjadayalan K., Wilkinson P., Marchant B., Timmis A. D. Reassessment of treadmill stress testing for risk stratification in patients with acute myocardial infarction treated by thrombolysis. Br Heart J. 1993 Nov;70(5):415–420. doi: 10.1136/hrt.70.5.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Struthers A. D. Plasma concentrations of brain natriuretic peptide: will this new test reduce the need for cardiac investigations? Br Heart J. 1993 Nov;70(5):397–398. doi: 10.1136/hrt.70.5.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Théroux P., Waters D. D., Halphen C., Debaisieux J. C., Mizgala H. F. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979 Aug 16;301(7):341–345. doi: 10.1056/NEJM197908163010701. [DOI] [PubMed] [Google Scholar]
- Weld F. M., Chu K. L., Bigger J. T., Jr, Rolnitzky L. M. Risk stratification with low-level exercise testing 2 weeks after acute myocardial infarction. Circulation. 1981 Aug;64(2):306–314. doi: 10.1161/01.cir.64.2.306. [DOI] [PubMed] [Google Scholar]
- Wilhelmsson C., Vedin J. A., Elmfeldt D., Tibblin G., Wilhelmsen L. Smoking and myocardial infarction. Lancet. 1975 Feb 22;1(7904):415–420. doi: 10.1016/s0140-6736(75)91488-9. [DOI] [PubMed] [Google Scholar]
- de Vreede J. J., Gorgels A. P., Verstraaten G. M., Vermeer F., Dassen W. R., Wellens H. J. Did prognosis after acute myocardial infarction change during the past 30 years? A meta-analysis. J Am Coll Cardiol. 1991 Sep;18(3):698–706. doi: 10.1016/0735-1097(91)90792-8. [DOI] [PubMed] [Google Scholar]
