Clinical Characteristics of Acute Myocardial Infarction Died during Hospitalization

ABSTRACT

BACKGROUND: Recently, the incidence of acute myocardial infarction (AMI) rapidly increased with prolongation of life spans, improvements of food and life styles in Korea. The mortality rate of AMI is higher than other disease. The purpose of this study is to evaluate which factors can affect the early outcome of AMI in Korean. METHODS: A retrospective clinical study was done on 555 consecutive patients{MaleFemale=387 (69.7%)168 (30.3%), mean age 61.3 years} with AMI who had been admitted to Dong-San Medical Center from January 1990 to May 1997 . The subjects were devided into two groups. Group I was dead patients during the in-hospital period (85 patients, 15.3%), and Group II was living patients (470 patients, 84.7%) wen they discharged from hospital. We compared clinical and laboratory results in both groups and analysed the cause of death according to the time of death during hospitalization. RESULTS: The results were as folows; 1) The mean age and female percentage of Group I (65.4 years, 43%) were higher than Group II (60.5 years, 28%). The mean of systolic/diastolic blood pressure and percentage of smoker of Group I (108/65mmHg, 48%) were lower than Group II (125/76mmHg, 65%), significantly. 2) The degree of Killip classification was higher in Group I (class 129.4%, II18.8%, III21.2%, IV30.6%) than in Group II patients (class 173.4%, II13.6%, III8.7%, IV4.3%), significantly. 3) 47 patients were died first day of hospitalization and the most common cause of death was cardiogenic shock (27 patients, 31%). The most common cause of death within 1 week was cardiogenic shock, afterthen congestive heart failure. 4) The most common cause of death in Killip class I patients was ventricular tachycardia or ventricular fibrillation and in Killip class II-IV patients was cardiogenic shock. CONCLUSION: The risk of in-hospital death was higher in elderly, female sex, and patients with higher killip classification. Cardiogenic shock was most common cause of death within 1 week, and was congestive heart failure after 1 week.