ABSTRACT
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. To identify, patients who have higher risk of in-hospital mortality after the first acute myocardial infarction. 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. 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. 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